Studia Liturgica An International Ecumenical Review for Liturgical Research and Renewal vol. 36 (2006) pp. 34-69

 I. Approaches;  II. Bonaventure;  III Catholic Ritual;  IV Updating

    In a 2005 contribution available on the World Council of Churches website,’1 His Holiness Aram I, Catholicos of the Apostolic Armenian Church of Cilicia and moderator of the Central Committee of the WCC, invites his audience to rediscover the Church’s ministry of healing in a world in “desperate need of healing in almost all spheres of human life.” According to Aram I, “healing belongs to the very esse of the Church,” and it is therefore necessary to correct “the prevailing missiological misconception that considers healing a ‘specialized ministry’ of the Church and neglects it as a core element.” Referring to the history of the ecumenical movement which, it seems, has never lost sight of this issue,2 he concludes that it is a question of coming to “an ecclesiological understanding that perceives healing to be integral to the Church’s being.”

    I understand his conviction as an encouraging call to responsible thought and action for the theologian of the sacraments. This French-language lecture should have been given by my former teacher and present colleague in sacramental theology, Professor Louis-Marie Chauvet, whose seminal work Symbole et sacrement remains one of the essential references for research in sacramental theology for the French-speaking world.3 _p.35

When it was suggested that I accept this speaking engagement in his place, and that I would do so under the planned conditions, in other words, that I should deal with the Congress theme of “healing a broken world” from the specific angle of sacramental theology, I began with a great deal of anxiety.

    In the works of sacramental theology from the past forty years, those that I know and above all those I have learned from, this theme is hardly taken into account. In the courses on the sacraments that I teach, this question is nearly absent, because my principal preoccupation is elsewhere. I try to respond to the question “Why do we celebrate the sacraments?” to explain the pertinence of sacramental practice in French society, where the sacraments are in decline.4 My emphasis on the meaning of the sacraments risks putting the question of knowing how the sacraments work in our lives into the background.

    In a world where medicine seems constantly to extend its reach, the question of sacramental healing could seem to be naively provocative. Yet, the Catholicos’ suggestions fortunately remind us that healing is at the heart of the Christian faith. Since “healing belongs to the very esse of the Church,” it is necessary to correct “the prevailing missiological misconception that considers healing a ‘specialized ministry’ of the church and neglects it as a core element.” Thus, I agree with the position that healing is “integral to the Church’s being.”5

    Since we seem to have lost sight of the relation between sacraments and healing, it seems useful to address the question from a historical perspective. I do not intend to present an exhaustive history, but simply to identify some aspects of the relation and contribute to our reflection. Though my starting point is an ecumenical text, I will focus on the Roman Catholic viewpoint in order to limit the scope of the question.

    I will combine two approaches: the history of sacramental theology and praxis and the method of models, understood here in the Weberian sense as “ideal images” that do not claim to describe reality, but rather define the angle of analyses.6 This modest proposal is heuristic; in other words, it seeks to define a question rather than to defend an argument. _p.36

    I will proceed in four steps. The first will try to define the question. The two following steps will propose two models. A last step will summarize the stakes and new issues, such as the relationship of human beings to illness in a world confronted with the progress and profound questions of medicine.

 I. APPROACHES to the ISSUE

    I will begin with an experience described in the context of WCC work. I will then return to Catholicos Aram I’s viewpoint before describing the development of the relationship between sacrament and healing in history.

    For some time, we have been witnessing a “better understanding of healing” as well as a renaissance in the church’s ministry of healing. A sign of this rediscovery is the recent world conference on Mission and Evangelism (CME) organized by the WCC under the auspices of the Church in Greece and which was held in Athens, May 9-16, 2005, under the title “Come, Holy Spirit, heal and reconcile!” Gathering more than 500 delegates from every continent and from every church and confession, this meeting wished to give to its participants “better means for forging communities that bring healing by their way of celebrating, of witnessing and of bearing reconciliation and forgiveness.”7

    In an article entitled, “The Churches and the Challenge of Healing in a Sick World,” written for this gathering in Athens, the Canadian journalist Hugh McCullum noted that if “faith healing and spiritual healing was always part of the ministry of the Church,” yet “for many they smack of magic, of mystical claims to ‘impossible healings’—so many elements completely foreign to ‘western’ models of religion.” But, conversely, he continues, “these models themselves are sometimes considered as leftovers of aging churches which have lost touch with the living source of healing power. At the heart of this tension, the largest pandemic of the modern world, HIV/AIDS, is in the process of changing the concept of what the healing ministry of the Church can mean.”8

    In this context, McCullum recounts the story of a eucharistic celebration with a healing service by a charismatic and theologically “orthodox” priest in an _p.37 Anglican parish of a Boston suburb.9 After having revealed to the congregation in his homily the existence of a healing service in the Book of Common Prayer, he proposed an anointing with oil and laying on of hands to all those who desired it. A man who had just been diagnosed with an advanced stage of cancer came forward. The priest prayed for him, for the doctors and for the treatments he had undergone. In addition, while he was praying for an elderly woman, he said, “I had the impression that she had something very serious with her pancreas.” A little while later, the doctor of the man with cancer declared cautiously a “sudden and inexplicable remission.” As for the old woman, a doctor she consulted after this celebration thanked her for having asked him to examine her pancreas because “during the examination he noticed the beginning of a problem.”

    The essential is not so much in the therapeutic efficacy of this celebration, and that to the benefit of the people who were not expecting this experience, but in the relation to the sacrament and healing that the author notices. In point of fact, a parishioner had said to the priest, “You don’t seem like a charismatic, you do not act like they do, you have never spoken of the gifts of the Spirit given in the Letter to the Corinthians.” In other words, the parishioner was amazed that the celebration of a sacrament could be effective without calling on the notion     of charismatic power.

What are we to make of such a story that has parallels in all churches and Christian confessions? There is a real difficulty today of thinking of the relation-ship between worship and healing. In the end, one would admit the possibility of miraculous healing, be it linked to a charismatic healer or with a place like Lourdes, but the idea that a sacrament could “heal” seems to have become foreign to our way of thinking.

This is where the intervention of the Catholicos Aram I becomes enlightening. For him, in effect it is Christ who is the foundation of the relationship between sacramentality and healing because he is the “great healer of all time.” Three major aspects renew the issue.

    1. Healing is anchored in the revelation of God. Thus it constitutes “an essential dimension of the mission of Christ, as well as a concrete manifestation of his work of redemption.” It is thus equally “a sign and an anticipation of the eschatological coming of the Kingdom of God (cf. Luke 10:9) and the participation in the Kingdom of God which will be totally complete in the parousia.” _p.38

    2. What is more, Christ entrusted the mission of healing to his disciples: “heal the sick, raise the dead, cleanse lepers, cast out demons; the Kingdom of God is among you.” 10And the Acts of the Apostles gives multiple testimonies to the fact that “healing became an essential component of the mission of the Early Church.” 11The transmission of the healing mission of Christ to the apostles and through them to the Church must affect ecclesiological concepts. By considering healing as “essential to the Church’s being,” the healing mission is placed at the heart of all activity of the Church as it is manifested through sacramental life, diaconal activity and evangelization. When the Church acts in the world, it is the healing work of Christ that it pursues, but this mission cannot be reduced to sacramental praxis.

    3. One would be able to confirm this by a study showing the importance of the theme in the New Testament.12 Even by limiting ourselves to the Gospel of Matthew, it appears very quickly that the vocabulary of healing—notably through the use of the terms therapeuo 13 and iaomai 14 is constantly present and that scenes of healing recur throughout the Gospel.15 Matthew goes so far as to view healing as a verification of the fulfillment of the scriptures. In Chapter 8, Matthew points out: “he . . . cured all who were sick. This was to fulfill what had been spoken through the prophet Isaiah, ‘He took our infirmities and bore our diseases’ “ (vv. 16-17).

    From these three preliminary remarks, we can already draw several key points.

1. If one considers the question of the relationship between sacraments and healing, it is the relationship between the mission of Christ and that of the church which appears immediately as an obligatory issue.16

2. In the second place, because healing appears in the gospel as an eschatological sign, the theme of “sacraments and healing” highlights the “sign” quality of the sacraments. Moreover, from this perspective, healing appears less as an effect to obtain than as a possible manifestation of divine grace given in order to strengthen  _p.39 faith. On this point, the end of the Gospel of Mark is even more significant by virtue of the post-paschal context: “And he said to them, ‘Go into all the whole world and proclaim the good news to the whole creation. . . . And these signs will accompany those who believe: by using my name they will ... lay their hands on the sick, and they will recover’ “ (16:15-18). This invites us to think about the relationship of healing and sacraments without forgetting that sacramental efficacy, with regard to the sick, belongs to the order of eschatological realities in the aftermath of the resurrection. The sacraments are not just another therapeutic process, but rather signs of the Kingdom which has come in and by the Passover of Jesus Christ.

3. In the third place, since healing attests the fulfillment of the scriptures, the link between the Word of God and sacraments of faith finds again its foundation. It is the Word made effective in the rite which is the power of healing, as one sees in Augustine, for whom the sacramentum is a verbum visibile or “consecrated by the words of the gospel.” It receives its force and its efficacy from the Word of God.17 The performative word of the scriptures is accomplished’18 in the sacrament which “effects what it signifies,” according to the Scholastic adage.

    Nevertheless, despite the massive presence of the theme in the New and Old Testaments, despite Christian praxis of the first millennium, it is possible to follow Aram I when he states that “in the later centuries, however, due to historical circumstances, healing lost much of its significance in the life and witness of the church.” 19 To begin to perceive this, we will limit our discussion to the development of the theology of the anointing of the sick and its effects.20

    In 850, the Council of Pavia considers bodily healing as an effect of the sacrament. In reference to the letter of James, it considers the anointing of the sick as a “saving sacrament” (salutare sacramentum) and a “great and very desirable mystery (magnum sane ac valde appetendum mysterium), by which, if asked for _p.40 in faith, sin is remitted and as a result also bodily health (corporalis salus) is restored.”21 It seems that this Council means above all to reaffirm the ancient discipline of the Decree of Innocent I (416) in which anointing cannot be given to penitents because it “is of the order of a sacrament” (nam paenitentibus istud infundi non potest, quia genus est sacramenti).22 In other words, anointing, being a sacrament, required, as did every sacrament, belonging to the communion of the Church in order to be celebrated in the faith of the Church.

    But by its very attachment to the ancient tradition, the canon of the Council of Pavia underlines the process of development by which anointing was going to become an integral part of penitence. Indeed, until the twelfth century, the most common order of the sacraments was:

l) penance, including reconciliation,

2) anointing, and finally

3) viaticum,

which shows “the importance of anointing as complement of penitence,”23 but also its own characteristic as sacrament for the sick and the specific place of viaticum as sacrament for the voyage. But from then on, it is the order of[:]

[1] penance,

[2] viaticum and

[3] extreme unction

that will be favored until the contemporary period, which, on the one hand, makes anointing the sacrament of preparation for death and, on the other, makes of penance the preparation for viaticum.24

    The Decree for the Armenians of the Council of Florence in 1439, after having defined the seven sacraments including “extreme unction” (extrema unctio), explains that the sacraments “contain grace and confer it on those who receive them worthily,” and in addition indicates that the first five sacraments—including extreme unction—have been ordained for “spiritual perfection” (ad spiritualem perfectionem). It works a kind of withdrawal with regard to the saving effect, by associating the effects of penance and anointing, which had been inseparable in practice since the medieval period:25

If, by sin, we fall into a sickness of the soul (aegritudinem animae), we are healed spiritually (spiritualiter sanamur) by penance. And both spiritually and  _p.41 bodily, according as our souls have need (spiritualiter etiam et corporaliter, prout animae expedit), we are healed by extreme unction.26

While the bodily effect of the sacrament is still maintained, especially since the epistle of James is considered as the text of institution, yet the essential effects move toward the soul, bodily healing being subordinated to the good of the soul. On this point the Council of Florence is an echo of high scholasticism since Hugh of Saint Victor,27 as well as Thomas Aquinas28 and Bonaventure,29 adopt this position. Nevertheless, the reflection of Saint Thomas in Contra Gentiles shows that this position is based on an anthropology of the sick person which gives to the body the status of instrument with regard to the soul. In this perspective, the infirmity of the body can be either useful to the soul—or on the contrary an “obstacle to the health of the soul” by hindering the exercise of the virtues—and in this case the healing of the body becomes useful to the health of the soul. According to Saint Thomas, “it is good that one can use against sin, to the degree that bodily sickness comes from sin, a certain spiritual remedy, a remedy by which can come the healing of the sickness of the body, when this is profitable for salvation.”30

    The decree of the Council of Trent only repeats this traditional teaching on the effect of the sacrament and assigns the effect on the health of the body to the last place, while allowing for the possibility of an eventual effect.31 _p.42

    A steady shift of accent from sickness toward sin thus evolved, which can lead one to think that it was favored by a focus on James 5:13-15, which became the major scriptural argument.32

Are any among you sick? They should call for the elders of the church and have them pray over them, anointing them with oil in the name of the Lord. The prayer of faith will save (sôsei) the sick person, and the Lord will raise him up (egerei), and anyone who has committed sins will be forgiven.

Without entering into a discussion on this text as scriptural foundation for the institution of the sacrament,33 one can note that this passage occurs in a kind of spiritual directory, which finishes at verse 16 with this advice: “Therefore confess your sins to one another, and pray for one another, so that you may be healed (iathète). The prayer of the righteous is powerful and effective.”

    The interpretation of this passage is difficult because of the ambiguity of the verbs sôzein and egerein, which can designate both recovery of health and eschatological salvation.34 One can underline nevertheless that this text designates forgiveness of sins as one of the effects of anointing, but without forgetting that the context betrays a perspective where the link between sickness and sin enters into a larger situation of spiritual combat where they become places of calling for confidence in God, coming from the promise that the prayer will be answered. _p.41

    The link between sickness and sin is thus essential even if it entails a fair reluctance for our mentalities. Certain New Testament texts seem to deny this connection, for example the story of the healing of the man born blind in chapter 9 of the Gospel of John. To the question of his disciples, “Rabbi, who sinned, this man or his parents, that he was born blind?” Jesus responds, “Neither this man nor his parents sinned; he was born blind so that God’s works might be revealed in him” (9:2-3).

    In the Old Testament, on the contrary, sickness is presented as the effect of divine intervention35 and constitutes—one can think here of Psalm 37(38)—a chastisement for sin. Yet because biblical anthropology does not separate soul from body, it is good to avoid a sequential understanding of this process, under the form: sin and, by consequence, sickness. In reality, humans are revealed as both sick and sinner, inseparably, and “in his testing, a person discovers himself in a new relationship with the one who at the same time strikes him, supports him and alone can heal him.”36

    Yet even in the New Testament, many healings, and notably that of the paralytic in Capernaum (Mark 2:1-12; Matt 9:1-8; Luke 5:17-26), show that this relationship between sickness and sin remains constitutive. When they bring the sick man to Jesus, it is as much in the sinner as in the paralytic that Jesus is interested. When they lower him through the roof, Jesus announces: “Son, your sins are forgiven” (Mark 2:5). In the second place, the healing of the paralytic appears as the sign given to the crowd that Jesus has the power to forgive sins (Mark 2:10-11). Finally, this miracle announces eschatological salvation in so far as the verb egerein is used also in Mark 12:26 with regard to the resurrection of the dead and the healing is presented as an unprecedented event.37

    Clearly, if there is really a link between sickness and sin, it is because Christ brings salvation to all, a salvation which is directed as much towards the death of sin as towards the death that sickness confronts us with and toward which it leads.

    It is good now to look at how these facts that we just considered figure in the two models chosen for their representative value. We will borrow the first model from Saint Bonaventure. The sacramental theology of Bonaventure is less called _p.44 upon in theological reflection than that of Saint Thomas Aquinas, but for the subject we are considering, it is more directly relevant because Bonaventure’s treatise on the sacraments is entitled precisely “Sacramental Remedies” (De medicina sacramentali). The second model is taken from a very different kind of source: the Roman Ritual of the sacrament of the sick from 1972, a sacrament that we just saw can be a good example of the relationship between sacraments and healing.

 II. ST. BONAVENTURE

    Among the medieval theologians, Saint Bonaventure (1217–1274) occupies, it seems, a unique place. Deeply marked by Franciscan thought,38 he favors a conception of theology in the line of Saint Francis that “refuses neither study nor science, but puts on them the condition that the brothers be detached from every spirit of possessiveness and that they be theologians ‘on their knees.’ 39The theological endeavor is thus inseparable from spiritual research, as the body of bonaventurian writings itself shows. Of these writings, two rank as major works: first, the Breviloquium—which H. de Lubac says “manifests a force of total synthesis that was perhaps never to be equaled”40—and second, the Itinerarium mentis in Deum, which witnesses to theological research conceived as a spiritual journey.41

    When Thomas Aquinas envisages the question of the sacraments, he first responds to the question of knowing what a sacrament is. He then deduces a series of consequences on their necessity, their effects, their causes, even their number.42 For Bonaventure, on the contrary, the sacramental section of the Breviloquium fits into a journey of man corrupted by sin, who returns to God thanks to the incarnation of the Word, the grace of the Holy Spirit, and sacramental remedies.

    The theology of Bonaventure, which finds its source in the Commentary on the Sentences,43 is thus directly linked to the thought of Peter Lombard, for whom the _p.45 sacraments were prefigured in the parable of the Good Samaritan: “The Good Samaritan, in approaching the wounded man, procures for his healing the bandages of the sacraments because against the wounds of original sin and actual sin God has instituted the remedies of the sacraments.”44 This position, which draws heavily on the patristic witness,45 finds expression in the thirteenth-century representations of the parable of the Good Samaritan that make the connection between creation, sin and salvation.46 In the stained glass windows of Chartres, for example, above the gospel story, it is all of salvation history which finds itself in relation with the acts of the Good Samaritan identified as Christ himself. Bonaventure strongly situates his theology in this perspective. The definition of sacraments contains the seed for everything, as proposed by Bonaventure right from the first chapter entitled De sacramentorum origine.

The sacraments are sensible signs, instituted by God as remedies (medicamenta) ... in which “secretly works, under the envelope of the sensible, a divine force” in such a way “that it represents by similitude, signifies by institution, confers by sanctification a certain spiritual grace.” By grace, the soul is healed (curatur) of the weakness of vice. It is primarily to that that the sacraments are ordained as their ultimate end; yet they serve also to humble, to instruct, to test. These are the secondary ends ordered to the principal end.47

This definition48 combines at the same time the sacrum secretum of Isidore of Seville, who attributes to the sacraments a hidden power—_[p.46] divina virtus secretius operator49—and that of Hugh of Saint Victor, who conjugates three aspects: the representation by similitude, the signification by institution, and the sanctification by conferring grace.50 It places healing as first effect of the sacraments, but it is a question principally of healing of the soul: per quam anima curatur ab infirmitatibus vitiorum. And if Bonaventure adds other effects of the sacraments—humility, instruction, and testing—they take second place. The explanation which follows is very enlightening and deserves to be studied closely.

    The principal healer, who is the crucified Christ, that is, the Word Incarnate, dispenses all things with a supreme wisdom because he is God, and heals in a very merciful way because he is divinely incarnate. He must restore and heal the sick human race in a way which suits the sick person himself, which suits the sickness, which suits the occasion and the healing of the sickness itself.51

    The spiritual medicine of the sacraments, according to Bonaventure, is thus in the prolongation of the incarnation of the Word. For him the physician (medicus) is the Word incarnate, the sick person is “neither just spirit nor flesh, but spirit in mortal flesh,” whereas the sickness is “the original fault which infects the spirit by ignorance and the flesh by concupiscence.”52

    This vision of the sacraments as remedy is thus linked to a conception of redemption articulated with a theological anthropology: “The origin of this flaw, which can be attributed principally to the consent of reason, finds nevertheless its opportunity in the flesh.” From that time on, so that the remedy corresponds, it is necessary that it not be “only spiritual, but also that it participate in sensible signs. Thus, the sensible, having been for the soul an occasion for falling, would furnish an occasion for recovery.”53

    Bonaventure then shows how the “grace of healing,” which “is not given to the prideful, to unbelievers or to the contemptuous,” requires that the sensible signs be given by God “not only to sanctify, to give grace and thereby to heal,” but again, “to teach by their signification, to make humble by their reception, to train by their diversity.”54 It is a question thus of a medicine which is above all spiritual, but which aims at the healing of a person considered as a whole. _[p.47]

    Let us summarize: the idea of medicina sacramentalis according to Bonaventure corresponds to a vision of salvation which includes the whole person. Yet the language used must not mislead us. Healing is essentially an eschatological sign of salvation which the Franciscan explains by linking the origin (ortus) of the sacraments, their use (usus) and their fruit (fructus): “At their source there is Christ the Lord; their use trains, instructs, and makes humble; their fruit is healing and the salvation of men.”55 In the context of scholastic causality, medicinal healing (medicinalis curatio) appears as final cause,56 and the corporal dimension passes clearly into the background to the benefit of sanctification. Bonaventure works thus a kind of conceptual slip from the medicinalis curatio to the medicamenta sanctificata because it is through the sacraments “that the soul is brought back from stain to sanctification.”57 From then, the sacraments are considered as realities that are so holy—Bonaventure multiplies the adjectives sancta, sacra and divina—that the memory of their effect on human life becomes blurred.58

 III. THE CATHOLIC RITUAL of ANOINTING of the SICK

A. A Diversified Rite: Sacraments for the Sick

    The next part of our reflection considers the new Ordo unctionis infirmorum eorumque pastoralis curae of the Roman Catholic Church published December 7, 1972.59 It has three main chapters. The first chapter, entitled De visitatione et communione infirmorum, concerns visits to the sick. It includes the rite of communion brought to the sick which constitutes a means of maintaining the union between the sick person and the eucharistic assembly and of supporting him/her by “this act of Christian fraternity.”60 The second chapter deals with the anointing of the sick. While presenting the rites, it also responds to a certain number of pastoral questions concerning the celebration of this sacrament. Thus, to the question “To whom must one give the sacrament?” the response is formulated in _p.48 this way: “One must be careful to give it to the faithful whose health has begun to be dangerously (periculose) threatened by sickness or age.”61 As for the question “Who is the minister of the sacrament?” the ritual keeps the discipline confirmed by the Council of Trent,62 which reserves the administration of this sacrament to the priest alone.63 Lastly, concerning the ways of celebrating, the ritual endorses a communal celebration within a eucharistic context and with a large gathering, this in part under the influence of the practice of pilgrimages, especially to Lourdes. The third chapter deals with communion and viaticum and is followed in the fourth chapter by an order for the sick in danger of death.64

    Thus there is not “a” sacrament but rather sacraments, in the plural, for the sick. This corresponds to an enlarged conception of sacramentality, which along the lines of K. Rahner or E. Schillebeeckx would include the sacraments in particular in a sacramental order in which Christ and the Church constitute the two foundational poles.65 The French-speaking ritual tends to underline, indeed to accentuate this orientation, in saying:

The sick person, threatened by the challenge of sickness and fighting against it, is helped in many ways, by his/her entourage, caregivers, and the Christian community. Among these acts of help and support, particular signs are offered to him/her, which witness in a special way to the love of God for and acting in him/her: the sacraments.66

In other words, the Catholic ritual for the sick includes a whole sacramental process which is not limited only to the anointing of the sick, but unfolds in a wider ensemble of “acts of help and support . . . which witness in a special way to the love of God” for the sick person, but also the love of God “acting in _p.49 him/her.” The model makes the sick person not only the beneficiary of different sacramental actions but also, in his/her way and for the community (hence the importance of the communal dimension), a sign of the presence of Christ. It is the sick person who is made a partner of the community in a sacramental order which goes beyond the administration of a particular sacrament.

B. The Meaning of a Recent Transformation

    In fact, the Second Vatican Council did not only renew the term onctio infirmorum in preference to extrema unction,67 but also recommended the sequence of penance, anointing, and eucharist.68 The significance of this change of order is great because it places anointing in the orbit of an ecclesial celebration of the paschal mystery as underlined by the Catechism of the Catholic Church (1992):

Like all the sacraments the Anointing of the Sick is a liturgical and communal celebration. . . . It is very fitting to celebrate it within the Eucharist, the memorial of the Lord’s Passover. If circumstances suggest it, the celebration of the sacrament can be preceded by the sacrament of Penance and followed by the sacrament of the Eucharist. As the sacrament of Christ’s Passover, the Eucharist should always be the last sacrament of the earthly journey, the “viaticum” for “passing over” to eternal life (CCC n. 1517).

While the eucharist in viaticum is clearly presented as the sacrament of the dying, the sacrament of the sick is a celebration of the Church, which associates the sick with the Passover of Christ and thus grants them strength and support to face their sickness. The basic reference for this renewed practice is to be found in n. 11 of the Constitution Lumen Gentium:

By the sacred anointing of the sick and the prayer of her priests the whole Church commends the sick to the suffering and glorified Lord, asking that He may lighten their suffering and save them (cf. Jas 5:14-16); she exhorts them, _p.50 moreover, to contribute to the welfare of the whole people of God by associating themselves freely with the passion and death of Christ (cf. Rom 8:17; Col 1:24; 2 Tim 2:11-12; 1 Pet 4:13).69

This brief but complex text finds its place in a wider discussion of the common priesthood of the faithful in the sacraments.70 The Catechism even sees a kind of inclusion between the sacraments of the sick and the sacraments of Christian initiation:

Thus, just as the sacraments of Baptism, Confirmation, and the Eucharist form a unity called “the sacraments of Christian initiation,” so too it can be said that Penance, the Anointing of the Sick and the Eucharist as viaticum constitute at the end of Christian life “the sacraments that prepare for our heavenly homeland” or the sacraments that complete the earthly pilgrimage (CCC n. 1525).

In other words, the sick person exercises the priesthood of the faithful by becoming a living memorial of the Christian life represented by the sacraments of initiation to the Passover of Jesus Christ and, at the same time, the one who in his sickness itself is configured to Christ in his death and resurrection, in conformity with the teaching of the apostle Peter: “But rejoice insofar as you are sharing Christ’s sufferings, so that you may also be glad and shout for joy when his glory is revealed” (1 Pet 4:13).

    This vision that is based on a theology of the paschal mystery reestablishes the sick person in the Christian community while the contemporary medical context tends very often to isolate him, even physically. The end of Lumen Gentium n. 11, which recalls the universal vocation of holiness, points toward a kind of “vocation” for the sick and of which certain saints such as Bernadette Soubirous and Thérèse of Lisieux constitute examples:

Fortified by so many and such powerful means of salvation, all the faithful, whatever their condition or state, are called by the Lord, each in his own way, to that perfect holiness whereby the Father Himself is perfect. _p.51

C. The Ritual and Bodily Healing

    The celebration of the anointing of the sick unfolds as a journey comprising four elements, as P. Gy underlined in his presentation of the new ritual: “the four principal elements of the sacramental celebration are the imposition of the hands of one or more priests, the ‘prayer of faith,’ the blessing of the oil and the anointing itself.”71 It begins with the entrance rites, including the greeting, the sprinkling rite, the instruction, the prayer and finally a penitential rite.72 The French-speaking ritual offers three choices for the prayer which aims at the same request: that the sick person and his entourage may receive strength in trial and that the sacrament “renew in him faith in Christ, hope for a better life, and love which will never pass away.”73

    The celebration continues by a liturgy of the Word74 which unfolds in a litany,75 then by the anointing of the sick which includes two fundamental acts: the imposition of hands and the anointing.76 The imposition of hands is a rediscovery in the new ritual which the formula of James invites (“prayer over the sick”),77 the meaning of which is given by the last formula of the litany: “that you may give life and salvation to our brother, N., on whom we are going to lay our hands.”78

    The French-speaking ritual offers four schemas corresponding to four different pastoral situations79 that imply some variants concerning the order of the ritual, notably concerning the place of the litany.80 We can understand from this that the place and role of community prayer, mentioned by the epistle of James, can be understood in a variety of ways.

    It is not our intention to review the entire ritual. We limit ourselves simply to how it treats the relationship between sacrament and healing, while the introductory material of the French ritual evokes the therapeutic efficacy of the sacrament: “When it is received in the faith of the Church, this sign (= sacramental celebration) is strength and comfort, support in testing, and leaven for victory over the sickness if God wills.”81 _p.52

    The prayer of blessing the oil is a reprise of the ancient prayer Emitte; it is reserved normally to the bishop and is included in the order of the chrism mass, but can be said in case of necessity for blessing the oil.82 Here one finds the affirmation of a bodily effect of the sacrament and indeed quite insistently so: “Send from heaven your Consoling Holy Spirit on this oil that your creation supplies for the strengthening of our bodies. May it become + by your blessing the holy oil that we receive from you, to relieve those who receive this anointing from sickness, body, soul, and spirit, to banish every pain, every physical, moral and spiritual evil.” It is only in the final petition that a more customary “spiritual” effect is mentioned: “May this oil become also the instrument which you use to give your grace, in the name of Jesus Christ, our Lord, who lives and reigns with you for ever and ever.”83

    This prayer is of great importance because it fulfills the same function as the blessing of water for baptism.84 P. Gy, who had shown the value of this benediction as euchological prayer,85 summarizes its doctrinal importance: “This is an epiclesis, a prayer of healing for every sickness, but at the same time it awaits from the _p.53 sacrament protection for the whole person, according to the Pauline trilogy of 1 Thess 5:23,” that is, the triology of body, soul, and spirit.86

    The Latin sacramental formula which accompanies the anointing—Per istam sanctam Unctionem et suam piissiamam misericordiam, adiuvet te Dominus gratia Spiritus Sancti. Amen. Ut a peccatis liberatum to salvet atque propitious allevet. Amen.87—leaves the question open, thanks to the use of the verb adjuvo (to help, to rescue), which can include both physical and spiritual effects. The French translation, by using the verb “réconforter” (strengthen) seems less inclusive: “N. by this holy anointing, may the Lord, in his great goodness, strengthen you by the grace of the Holy Spirit. Amen. Thus, having been freed from your sins, may he save you and raise you up. Amen.”88

    We find the theme of healing in the prayer which follows the anointing. The French-speaking ritual offers six choices for the prayers, in view of the particular situation of the sick person. These prayers are for the most part new creations.89 Many contain formulas explicitly asking for healing, such as: “By the grace of the Holy Spirit, heal him from every evil, forgive his sins, take away from him all that causes him suffering, restore him to health, so that he can take up again among us the work that awaits him.”90 One of these prayers is even completely oriented to the request for the return of health: “May he find health again, so that he can resume a normal life and, with a renewed heart, give you thanks in the assembly of your faithful.”91

    In summary, we see easily that the Roman Ritual of the anointing of the sick corresponds to a vision of the sick person which does not separate “the body, the soul, and the spirit” but takes into account a person called to enter, through his trial, into the paschal mystery of Christ. Healing or strengthening given to the person comes first. The forgiveness of sins is certainly not forgotten, but the rediscovery of the sacraments for the sick has allowed a rebalancing of thought in the direction of a preparation for life, whereas the notion of extreme unction had led us to consider it almost exclusively from the penitential point of view.

    In addition, like every sacrament, the anointing of the sick includes a communitarian dimension, regardless of its mode of celebration. But the invitation to celebrate it within a eucharistic celebration is one of its major signs. In this, the _p.54 ritual reintroduces the sick person into the heart of the community with a view to making him a living member of the church of which the assembly is the sign. It is in this light that one can understand the importance given to the ministry of the priest in a celebration: it underlines the strong ecclesial weight of this celebration, an ecclesiological dimension which must be seen in the context of the poor and the sick who are the first recipients of the Good News.

    We are here rather far from the model developed by Bonaventure. Physical healing is asked of God as a gift of the Holy Spirit, this same Spirit who heals the body as the tradition expresses it in, for example, the sequence of Pentecost: Veni Sancte Spiritus: “sana quod est saucium.”92 Healing invites the sick person to participate in the construction of Christ by becoming a member of the body of the saved called to enter into the Kingdom.

IV. Conclusion: An Attempt at Updating

A. What is at Stake

    In this research we should have been able to consider also an example from the first millennium, notably from the patristic period. If we have preferred to omit this supplementary investigation, it is for several reasons—first of all, of course, our limited time. Then for the reasons of the complexity of the hermeneutic of the literature of the first millennium on this point, a period where neither the sacraments, nor sickness, nor healing would be considered with the same criteria as today. We can note here, following P. Gy, that the ancient church, at least according to the letter to Decentius (of Gubbio), seems not to have known any sacramental formula accompanying the anointing.93 What is more, the anointing would seem to be able to be done by a lay person and maybe even by the sick person.94 This signifies that the ritual followed quite another logic than that put in place in the Middle Ages. Finally, it is necessary to take into account the fact that it is in the middle of the twelfth century that one begins to see the emergence of sacramental doctrine and that the concern for coherence in the subject favored our omission of a patristic model.

    We must add that we have made a parallel between the medieval theological model of Bonaventure and a contemporary liturgical model, but which has its sources in much older strata of the Tradition as we saw, for example, with the prayer for the blessing of oil. One must not, however, judge one in the light of the other. A _p.55 comparison between these two models asks us rather to consider that the theological logic and ritual logic do not follow the same language, the same path, or the same rhythm. Sacramental theology in the Roman Catholic world is often caught between doctrinal pronouncements of the past which received a canonical status at the Council of Trent and the liturgical practices that the Second Vatican Council renewed in drawing on the treasures of the practices of the first millennium.

    On the topic that concerns us, it seems to me possible to conclude that there is tension between ritual practice and received theology. On one hand, in the line of the solicitude of Jesus toward the sick, the ritual considers bodily healing as the first goal of the celebration in so far as it is the sign of salvation realized for the sick person but also for the Christian community which surrounds him. The gospel passage which best evokes this orientation is found in chapter 18 of Luke’s Gospel, with the healing of the blind man of Jericho:

They told him, “Jesus of Nazareth is passing by.” Then he shouted, “Jesus, Son of David, have mercy on me!” Those who were in front sternly ordered him to be quiet; but he shouted even more loudly, “Son of David, have mercy on me!” Jesus stood still and ordered the man to be brought to him; and when he came near, he asked him, “What do you want me to do for you?” He said, “Lord, let me see again.” Jesus said to him, “Receive your sight; your faith has saved you.” Immediately he regained his sight and followed him, glorifying God; and all the people, when they saw it, praised God (vv. 37-43).

    On the other hand, the theological elaborations developed a theology of the sacrament which, founded on a reading of the letter of James, detached from the example of Jesus himself, tends to favor a “spiritual” effect, an effect of “grace” for which healing can only be an imperfect sign. Hence the tendency to give to the sacrament the first goal of salvation, but salvation understood under the angle of the remission of sins, to the degree that theology was constructed at a time when the sacrament was lived under the model of extreme unction.

    This tension makes it a delicate task to take into account the questions currently raised by the evolution of medicine in the contemporary world, questions which lead one not only to challenge the efficacy of medical techniques but also to consider the sick person as a complete being, and to consider him in his globality.

    In a bestselling book, Professor David Servan-Schreiber, doctor and specialist in the cognitive neurosciences,95 recalls how he found himself questioned by _p.56 some experiences which he believed indicated the failure of the medicine he had been teaching: “If,” he says, “after so many years of study and of formation, I was incapable of helping someone who mattered so much to me, what was the use of all this knowledge? In the course of the following months and years, I learned to open my spirit to numerous other ways of caring, and I discovered, to my great surprise, that they were not only more natural and more gentle, but also often more effective.”96

    But for the sacramental theologian, the question resides less in the diagnosis of failure than in the way chosen by the researcher to exit from it. He proposes, in effect, a medicine that takes into account the emotional life of patients and no longer considers the sick person as an object: “a new medicine of emotions is being born today . . . we have explored how to relieve depression, anxiety and stress with a group of methods which call above all on the body rather than language. This book describes the different components of this program, why we have chosen them, and how we have used them.”97 The preoccupations of a society characterized by stress, anxiety and depression join a strong trend of resistance to medical protocol that is more and more burdensome and costly for patients, and all this together is generating a major interest for this kind of rediscovery.

    The theme “sacrament and healing” thus resonates with the concerns of contemporary medicine. Of course, it is not a question of treating the sacraments, especially the anointing of the sick, as a specific technique of this “medicine of the emotions.” It is rather a question of understanding this type of research as an interpellation for taking seriously the power of sacraments in the matter of healing. The basic question can thus at the end of our study be reformulated in the following way: How are the Christian sacraments important for a world waiting for healing? In what and how do the Christian sacraments contribute specifically to this work of healing claimed not only as an essential dimension of the Christian vision of salvation but also as a possible way for the contemporary search for health?

B. A Continuing Reserve in Contemporary Theology

    Yet when one considers contemporary theological writing on the sacrament of the sick, it seems that a real constraint remains when it is a question of envisaging _p.57 how a sacrament can be effective, including as a way of healing. We can see it in considering the proposals of some recent theologians.

    In a stimulating work from 1971, the Jesuit Bernard Sesboüé proposed under the title “Anointing of the sick, expression of the Good News in face of the fragility and finitude of human existence” some directions for a “new portrait of the anointing of the sick.”98 We can underline the word “expression” even if the principal aim of the author cannot be reduced to the use of this term. Sesboüé intends to take into account challenges to the attitude of the Church toward sickness and death.99 His thoughts are expressed through four reflections which are found at the juncture between pastoral concern and theology.100 The third is formulated as a promise: “Anointing must announce that Christian salvation is interested in the whole person” because the church “is interested at this moment in the body.” But in reality, it is for Sesboüé less a question of envisioning an effect on the body than of noting that it is given to the anointing of the sick “to highlight the love of God for our bodies, for which he desires healing and resurrection.” 101

    In the same period, Claude Ortemann concluded his book on the sacrament of the sick with an essay on its theological significance.102 Among the five affirmations of this text, two of which concern the forgiveness of sins, the author notes that anointing “procures the relief of sick person” but he understands this as “the reconciliation with the body,” “the restoration of solidarity with the world” and “ the integration of finitude and death.” And while he considers that anointing gives “a sense of healing,” the weight of his argument leans toward what might be the “meaning” of a healing if it occurs: “The sacrament gives to healing the sense of a new situation offering to divinized freedom a Christian task to realize, according to the meaning conferred on existence during the sickness.” 103

    More recently, in 1999, in an issue of La Maison Dieu entitled “Human Fragility and Liturgy,” offering the state of research nourished by pastoral work in a hospital, Louis-Michel Régnier tries above all to widen the perspective as much on the sacramental level as on the level of salvation. He does so in the wake of the work of L.-M. Chauvet for whom the sacramental dimension is “one of the constitutive dimensions of faith and of Christian existence,” which “is manifest and crystallizes in the sacraments” but where “the sacramental surpasses generally the particular sector of the sacraments.” 104

    Two affirmations show perfectly this refusal to be boxed in, ritually or theologically, in ways too narrow for taking into account the “partnership” 105which must necessarily mark solicitude for the sick. The first places anointing of the sick “at the heart of multiple signs capable of taking into account the presence of God,” and consequently “all that contributes to embracing the humanity of the one who has experienced vulnerability can become the place itself of the presence of God.” 106The second envisages the “relationship between healing and salvation,” but does so in order to underline that “healed physically or not, the sick can have the experience of a new life in spite of all”—which tends to relativize healing.107

    In all these three writers, it is striking that the question of healing is eluded to the profit of the consideration of the relation of the sick person himself, the relation between healing and salvation, or the meaning of healing. One can think that these accents are shared by most French-speaking theologians today.

C. Toward Healing Communities

    In France, currently, a good number of new communities, notably those that are connected with the charismatic movement,108 are developing services of healing, but to my knowledge at least, outside of charismatic circles themselves, the relationship between healing services and sacramental theology has benefited very little from taking these experiences seriously.109

    To consider this delicate question, the response to which goes beyond the object of this exposé, I have proposed a reflection using the method of different models. It was a matter of better understanding how the question was posed in the past and how it works in the current ritual. I hope I have clarified a little how it is possible to think about it today, in a context of transformation of the manifestations of healing, of medicine, and of sacraments.

    The point of convergence between current secular research around the questions of healing and theological research in the sacramental domain seems to me to be the idea of “healing communities”: for the sacramental theologian, influenced by Rahnerian theology, this aspect is decisive. In effect, in a world dominated by the media which tends to promote personal charisms of healing, attention to the sacramental question can help not only to avoid so many deviations towards gurus and charlatans, but also allow the church, our communities, to become anew the sign of Christ who heals by way of human instruments.

Translated by Laurence de Talençay and Douglas Martis;
translation revised by Katherine Shirk Lucas

....x....  ’ “”.