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The Church’s ministry of healing

The Church’s ministry of healing covers a very wide range of activities, not all compatible with one another. ‘Healing Service at 6.30 p.m. Come and experience a miracle’ says the poster outside a rather shabby corrugated-iron evangelical tabernacle in the inner city. People with back pain come and receive prayer. It is all very informal and rather noisy. One or two go away saying the pain has gone, others are disappointed. In the large Pentecostal church some distance away, the statement of faith includes: ‘We believe that deliverance from sickness, by Divine Healing, is provided for in the Atonement.’ They, too, offer services of divine healing on a regular basis. The local Reformed church, by contrast, believes that the age of miracles lasted while there were apostles, but has long since passed away, and that contemporary claims to miracles are misguided at best, and possibly of the devil. An Anglican church in the suburbs is more sedate. There is an occasional service of healing, but the context is the liturgy of the Eucharist, laying on of hands and anointing with oil, and a formal prayer.

People find it comforting to be part of a service, and some attend regularly for a sort of spiritual pick-me-up, but not many people talk about miracles. A little miracle happened, however, in one woman’s lounge when a friend was praying for her, and unexpectedly she felt a significant change for the better had occurred within her body, which the doctor subsequently confirmed. So was this a ‘gift of healing’?

There is the Christian doctor who believes that the restoration of God’s image is spiritual and not physical, as death is inevitable, and that the priorities of the gospel are eternal salvation, not temporary respite for ailing bodies. We should not therefore, in his view, put our faith in miraculous cures. His perspective would be that we should look to the doctor for health in our bodies, and to the Church for help with our souls. On the other hand, there is the Christian health worker who wonders how Christian healing relates to the increasingly technological approach to medicine in many of our hospitals. What are we doing when we use sophisticated scanners and dialysis machines? What do we think of medical technology when we are faced with incurable conditions, and what does that do to our view of human vulnerability in the face of disease?

The health centre has a counselling agency staffed by Christians. They are seeking to express their faith through their professional work, and look with suspicion at the new Christian counselling agency that has opened in a local Methodist church hall. But what is ‘Christian’ counselling, and how does it relate to the accredited work of the British Association for Counselling and Psychotherapy? And what is to be made of the change of attitude among many Christians in recent years concerning such therapies as osteopathy and acupuncture? A generation ago these were suspect; now, for many people, they seem routine.

Three decades ago, a young Christian family doctor called James Casson was diagnosed with a terminal illness, and he wrote of his experiences of dying in a small booklet entitled Dying: The Greatest Adventure of My Life.[1] He wrote of the practical problems of dealing with cancer, he wrote of Christian hope, and he included a section on divine healing. In a measured way he argued that the medical profession should be more open to the healing love of God, but described his own ‘healing’ in terms of emotional strength when he was very depressed, and specific answers to prayer over some more distressing symptoms that he was sure were psychosomatic in origin:

Release came with the realization that the whole issue was out of my hands . . . the great joy was that the Lord was at the tiller, his face gently smiling and his eyes twinkling as he quietly guided me to my destination. Was I healed? Yes, I believe I was.

So it is clear that what is described as the Church’s ‘ministry of healing’ covers a very wide range, and over the centuries it has covered most of the emphases given in the above paragraphs. It includes the Church’s commitment to medical care and its own specific ministry of sacramental healing through prayer and anointing, as well as more informal approaches. The Church has been involved in the founding of hospitals: there was one founded by St Basil in the fourth century; the Augustinian canons founded St Thomas’ Hospital in London in the twelfth century. St Christopher’s pioneer hospice was established in Sydenham in 1967. The Church has also contributed to the training of doctors and the setting up of medical missions. In addition, the Church’s pastoral ministry includes a strong interest in counselling and psychotherapy and there are a number of Christian agencies for counselling. This includes pastoral care for individuals, along with a social commitment to the health of the wider community. This is not to say, however, that the Church’s role in the ministry of healing has been consistent. In different places, at different times, in different Christian denominations, the emphasis placed on healing has been very varied.

On the one hand, some parts of the Christian Church seem to have abandoned any interest in healing ministry, operating with a split view of a person that leaves healing to the medical profession while the Church concentrates on preaching the gospel for the salvation of the soul. I shall argue that this split view does not do justice to the New Testament image of people. On the other hand, parts of the Christian Church have become so absorbed with healing ministries of different sorts that they give the impression that health is a sort of commodity that can be accessed if only we say the right prayers, or do the right liturgical actions. This mechanizes health in a way that the Bible does not, and if unchecked can lead to an idolatry of health. It can also raise wholly unrealistic expectations of the miraculous healing of all disease, which can do considerable harm.

This book attempts to chart a course between different viewpoints, guided by the overall theme that the Church’s pastoral ministry is given its meaning by, and caught up into, the ministry of Jesus. We will focus on the Church’s healing ministry in its broadest sense, and the fact of pain, suffering and continuing ill health will obviously need to be part of the story. We shall discuss Christian pastoral counselling, some of the values that underlie pastoral care, and concentrate in Chapter 4 on ministry with people who are particularly vulnerable because of abuse they have suffered. We conclude by looking at the relationship between health and salvation, and explore the sacramental ministry of prayer and anointing. So our purpose is to offer some theological reflections on Christian pastoral care in relation to the question of health. For underneath all this is the question of what is meant by ‘health’.

What is health?

The word for ‘good health’, used in the prayer in the Third Letter of John, also means ‘wholesome’ and ‘sound’: ‘Beloved, I pray that all may go well with you and that you may be in good health, just as it is well with your soul’ (3 John 2). So what does ‘good health’ mean?

One famous, or notorious, definition of health was offered by the World Health Organization: ‘Health is a state of complete physical, mental and social well-being, not simply the absence of illness and disease.’ This is both too limited and too broad. It is too limited in that it makes no reference to a person’s spiritual progress as part of the meaning of health, and in that it concentrates on a ‘state’ of well-being, whereas human life is a constantly changing journey. But it is also too broad in failing to recognize the inevitability of ageing and death, and offers too utopian a vision of life without pain, and no recognition of the redemptive possibilities that suffering can sometimes bring. More simply, and more satisfactorily, the theologian Jürgen Moltmann suggests that health is ‘the strength to be human’. His conclusion is worth quoting:

If we understand health as the strength to be human, then we make being human more important than the state of being healthy. Health is not the meaning of human life. On the contrary, a person has to prove the meaning he has found in his own life in conditions of health and sickness. Only what can stand up to both health and sickness, and ultimately to living and dying, can count as a valid definition of what it means to be human.[2]

Disease, illness and sickness

Some people understand health mostly in relation to disease: an objective condition concerned with those parts of our bodies that are not functioning properly. I visited Zambia with Christian Aid a few years ago, and met a woman, Theresa, in her late twenties, sitting on the floor of her small mud house. Her body was desperately weak through contracting the HIV virus via a blood transfusion. Her ‘lack of health’ was in large part due to the intrusion of a virus into her bloodstream. If health is the absence of disease, then healing becomes restoring proper functioning to an organ, or to the body as a whole. For Theresa it might have meant anti-retro-viral drugs, until something better was discovered – if she could afford them that is, and if there was nursing care available to help her take the medication.

Others understand health as the absence of illness: this is a more subjective word. When I feel ill, it may be the result of some disease, or it may come from more complicated emotional factors such as relationships being strained, or the environment in which I live being too stressful. Healing, then, comes to mean the restoration of a person’s sense of their own well-being. In Theresa’s case, her suffering was made considerably worse by the fact that her whole family had disowned her when she admitted to having the so-called ‘stigma’ of AIDS. She had been left to the care of some voluntary nurses who worked at a Catholic centre on the compound where her small house was situated. They were able to call on her a few times a week, with a little food, and some oil to rub into her ulcerated skin. The obvious emotional distress of being abandoned by her family simply compounded the disease itself.

Yet others think of health primarily in relation to what we may call ‘sicknesses’. We can understand this as a social definition. A person is sometimes said to be ‘sick’ if they do not fit in with society’s understanding of what is ‘normal’ and ‘healthy’. A few decades ago, behind the Iron Curtain, a person who did not comply with society’s political ideas was defined as ‘sick’, and treated in a psychiatric hospital. Others are defined as ‘sick’ if they do not conform to what society expects of them because of their sexual orientation, or the shape of their nose, or some mental handicap; sometimes it can even be the process of simply growing old. Of course, it may be that ‘society’ itself is ‘sick’ rather than the individual who does not fit in. Either way, someone’s social environment can be significant in relation both to disease and to illness.

For Theresa, her situation was made even harder by anxiety concerning her two young children. They attended a school where 75 per cent of the pupils were affected by the HIV virus within the family, and many were already orphans. When I visited the school of 730 pupils, there was a staff of ten, only two of whom were trained teachers. The sad fact was that there were several thousand unemployed teachers who had been fully trained in Zambia, but they were unemployable through lack of finance. There were insufficient resources for proper care of the children – what would ultimately happen to Theresa’s? The ‘sick economic context’ of Theresa’s society was a major factor in her own health and that of those around her.

To give a different example, down the middle of the street in Matopeni, one of the slums of Nairobi in Kenya, is an open sewer in which human waste and all other rubbish is thrown. There is a little bridge over the sewer, and people walk across this and children play and scavenge nearby. No clean water there, or toilets, or showers. The brute fact is that one in eight people on this planet has no access to clean water. Matopeni is a small settlement. Sixty per cent of the people of Nairobi live in slums. Matopeni means ‘in the mud’. There is little dignity there, and health is poor. HIV and typhoid are widespread. There is lack of education, bad housing, bad food, bad clothing. So morale diminishes, behaviour becomes antisocial; men drink too much; and the young girls go into the sex industry to try to scrape together enough money to feed the children.

One local woman, Catherine Kithuku, caught a vision for change, and became determined to improve living standards. Catherine and her friend Veronica set up a community group, mostly made up of single mothers, concerned for the welfare of their children. With support from a local Christian Aid partner organization, Catherine Kithuku has been working for the Matopeni community to construct a water and sanitation block to improve health and generate a small income. This is her prayer:

I pray for change. I pray to live a clean, comfortable life, with privacy. I pray to see my family move out of slum life. I would ask people to pray for better housing, for children to be educated, for jobs for the young people, and support for single parents and the elderly. But most of all I pray for clean water. Without clean water we get sick. We have a lack of money and cannot afford to buy water. It will help bring a change in attitude. People will clean themselves more; they will clean their houses more; it will lead to a clean environment in more ways than one.[3]

‘Health’, then, is a broad term. It covers viruses and bacteria, and deals with the body as a functioning biological whole. It affects the individual person at many levels, physical, biological, psychological, social, moral and spiritual. Health is related to families, the individual person in a network of relationships with other people. It reaches out into the neighbourhood. The social setting of our lives impinges on our health in many different ways. Another dimension of health is ecological: the wider environment of clean water, traffic noise, air pollution, climate change.

The Christian ministry of healing must concern itself with all these aspects of health. From the management of disease, to nursing care; from learning through suffering to finding new ways of being strong and healthy. Christians will be interested in surgery and medication, concerned with emotional health, counselling and therapy. Christians will care about the social pressures that make for illness, and seek for justice, which is the expression of love in our social environments. Christian concern will extend to the wider environment of the planet, the air we breathe, the quality and sufficiency of food supplies, the need for clean water. Health will embrace the whole of our spiritual environment before God. We are concerned not only with removing what is wrong, but with promoting what is healthy: community care, public health, spiritual well-being.

A whole person

Underneath these Christian concerns is the conviction that a person is not to be split up into different parts, but thought of as one spiritual–psychosomatic whole.

We recall the prayer in 3 John, where the author prays for ‘good health’, and then adds, ‘just as it is well with your soul’ (3 John 2). The impression is given that body and ‘soul’ are separate parts of the person. In fact, they are better understood as different perspectives on the whole person. Even the New Testament phrase ‘spirit and soul and body’ (1 Thess. 5.23), which looks as though it splits us up into three separate components, is used to refer to the whole person from different points of view. The nineteenth-century biblical scholar J. B. Lightfoot comments on this verse that ‘spirit is the ruling faculty in man . . . through which he holds communion with the unseen world’; the soul is ‘the seat of all his impulses and affections, the centre of his personality’; while the body ‘links him to the material world and is the instrument of all his outward deeds’.[4] In the history of the Church there have indeed been times when Christians have operated with a split view of matter versus spirit, body versus soul, but today many are returning to the view – much more characteristic of the Bible as a whole – that human beings are complex creatures, functioning at many different levels, and in whom body and emotions, relationships and environments are all part of what it is to be human, and all these aspects have their part to play in our understanding of health. One contemporary biologist cautions against a ‘reductionist’ view:

If humans are to be understood essentially in terms of genes and their products, then illness is to be corrected by manipulating them. The result is drug-based medicine and genetic counseling or engineering. These can be extremely effective in certain circumstances, but medical care based on this approach focuses on illness rather than on health.[5]

Shalom

To explore a Christian understanding of health, we need to turn to the witness of the Old and the New Testaments. We begin with one significant Hebrew word: shalom.

Most frequently translated ‘peace’, shalom means much more than the absence of conflict. It is also translated as good health, favour, completeness, prosperity, rest, welfare. Shalom carries the sense that all is well, peaceable and safe. Therefore shalom is much more than the absence of disease, broader even than the absence of feeling ill. Health is part of shalom, the wholeness of life whereby each dimension of our being – physical, relational, emotional and environmental – is open to God and God’s ways. The vision of peace in Isaiah 2.1–5, which could almost be a definition of shalom, is set in contrast to the sickness of the nation (1.5–6), its idolatry (2.6–22) and the social injustices (3.13–15) that bring the judgement that the Lord will not be a healer (3.7b).

It is a longing for shalom that the psalmist expresses when he writes: ‘There is no soundness in my flesh because of your indignation; there is no health in my bones because of my sin’ (Ps. 38.3). It is shalom that the psalmist celebrates: ‘Let those who desire my vindication shout for joy and be glad, and say evermore, “Great is the Lord who delights in the welfare [shalom] of his servant”, (Ps. 35.27).

The social dimension to shalom becomes very evident in Jeremiah’s plea that the exiles should pray for the city in which they find themselves: ‘But seek the welfare [shalom] of the city where I have sent you into exile, and pray to the Lord on its behalf, for in its welfare you will find your welfare’ (Jer. 29.7).

The wider environmental dimensions of shalom are clear in Isaiah’s vision of the coming abundance of life when all people return to the Lord and his ways:

For you shall go out in joy, and be led back in peace; the mountains and the hills before you shall burst into song, and all the trees of the field shall clap their hands. Instead of the thorn shall come up the cypress; instead of the brier shall come up the myrtle; and it shall be to the Lord for a memorial, for an everlasting sign that shall not be cut off. (Isa. 55.12–13)

This vision speaks of a healed environment when God’s kingly rule is established. As the Catholic theologian Hans Küng once famously wrote: ‘God’s kingdom is creation healed.’[6]

Each part of the prophecy of Isaiah has its emphasis on shalom. The first part of Isaiah speaks of the coming kingly rule of God’s Messiah as a rule of shalom, of peace, justice and righteousness. The coming One is named Prince of Peace (shalom) (Isa. 9.6–7). In the second part of Isaiah, God’s kingly rule is a recapitulation of God’s eternal covenant of peace: ‘For the mountains may depart and the hills be removed, but my steadfast love shall not depart from you, and my covenant of peace [shalom] shall not be removed, says the Lord, who has compassion on you’ (Isa. 54.10).

In the third part of Isaiah, the preacher stands in the shoes of the coming king and announces that God has anointed him ‘to bring good news to the oppressed, to bind up the broken-hearted, to proclaim liberty to the captives, and release to the prisoners; to proclaim the year of the Lord’s favour and the day of vengeance of our God’ (Isa. 61.1–2).

Naturally, when centuries later Jesus ‘went about all the cities and villages, teaching in their synagogues, and proclaiming the good news of the kingdom, and curing every disease and every sickness’ (Matt. 9.35), it was understood that Jesus was the bringer of shalom. In fact, he applies the text from Isaiah 61 to himself in the synagogue at Nazareth (Luke 4.1–16), and Matthew records John the Baptist’s question of Jesus:

‘Are you the one who is to come, or are we to wait for another?’ Jesus answered them, ‘Go and tell John what you hear and see: the blind receive their sight, the lame walk, the lepers are cleansed, the deaf hear, the dead are raised, and the poor have good news brought to them.’ (Matt. 11.3–5)

This echoes the passage in Isaiah 35.5–6, which describes God’s salvation of Israel and the health-giving signs of the messianic age: salvation and health belong closely together; here is the kingdom of peace; Jesus is the bringer of shalom.

Healing in the New Testament

As we will discuss more fully, Jesus exercised a very extensive ministry of healing. This ministry continues into the New Testament church, and gifts of healing were referred to in some of the New Testament epistles (1 Cor. 12.9) and the Acts of the Apostles. The apostles demonstrated many signs and wonders among the people (Rom. 15.19; 2 Cor. 12.12), and in the post-Pentecost church many of the sick and those afflicted with unclean spirits were healed. Peter and John healed a man lame from birth, in the name of Jesus (Acts 3.6). At one time the sick were laid on cots in order that Peter’s shadow might fall on them as he passed by, so that they might be healed (Acts 5.12–16). Philip was instrumental in the cure of people possessed, or suffering from paralysis (Acts 8.6–8). Paul and Barnabas were able to speak of signs and wonders (Acts 15.12), and God, we read, performed extraordinary miracles through Paul: handkerchiefs and cloths that had touched his skin were brought to the sick and they were cured (Acts 19.11–12). By prayer and the laying on of hands, Paul cured the father of Publius of his fever and dysentery (Acts 28.8).

Matthew says that disciples ministered to Christ by ‘visiting those who are ill’ (Matt. 25.39), and John tells us they prayed for one another ‘that you may be in good health’ (3 John 2). The practice of anointing with oil, and praying for those who were ill by calling for the elders of the Church, is referred to in the Letter of James (5.13–15).

Not everyone was healed, however. Paul himself refers to his own ailment as a ‘thorn . . . in the flesh’ (2 Cor. 12.7), with which God gave him the grace to cope. This ‘thorn’ has been variously interpreted as an eye disease, a form of epilepsy, a susceptibility to malaria – or maybe some psychological distress following the opposition to his ministry, or his anguish resulting from the unbelief of his Jewish compatriots. Indeed, speculation has been very wide, and certainty about this is impossible. We are told that Timothy had stomach trouble and ‘frequent ailments’ for which Paul prescribed ‘a little wine’ (1 Tim. 5.23); Epaphroditus became so ill that he nearly died (Phil. 2.27); and Paul had to leave Trophimus behind when he left Miletus, because he was ill. Weakness and illness – indeed some deaths – were put down to inappropriate use of the Lord’s Supper (1 Cor. 11.30).

Jesus refers to physicians in the Gospels, even of a poor woman who had suffered at the hands of many of them (Matt. 9.12; Mark 2.17; 5.26; Luke 8.43). Luke was a doctor, described by Paul as ‘the beloved physician’ (Col. 4.14). Both Paul and Luke would have known the paragraphs from the second- century bc book of Sirach, which refers to medical skill, indicating that medicines are gifts of the Creator, and yet recognizing the limitations of medical intervention and the need for prayer. It even says that it can be seen as a punishment to fall into the hands of a doctor!

Honour physicians for their services, for the Lord created them; for their gift of healing comes from the Most High, and they are rewarded by the king. The skill of physicians makes them distinguished, and in the presence of the great they are admired. The Lord created medicines out of the earth, and the sensible will not despise them. Was not water made sweet with a tree in order that its power might be known? And he gave skill to human beings that he might be glorified in his marvellous works. By them the physician heals and takes away pain; the pharmacist makes a mixture from them. God’s works will never be finished; and from him health spreads over all the earth.

My child, when you are ill do not delay, but pray to the Lord, and he will heal you. Give up your faults and direct your hands rightly, and cleanse your heart from all sin. Offer a sweet-smelling sacrifice, and a memorial portion of choice flour, and pour oil on your offering, as much as you can afford. Then give the physician his place, for the Lord created him; do not let him leave you, for you need him. There may come a time when recovery lies in the hands of physicians, for they too pray to the Lord that he will grant them success in diagnosis and in healing, for the sake of preserving life. He who sins against his Maker will be defiant towards the physician [or: may he fall into the hands of the physician].[7]

Because of sin and death, we need an approach to health that recognizes human frailty, suffering, disease and mortality, but we also need one that acknowledges God’s gifts of healing through medicine and pharmacy as much as through prayer.

The healing ministry of Jesus

The pastoral ministry of the Church needs to be part of the ministry of Jesus, for he is the Church’s pattern and the Church’s resource. The Letter to the Ephesians makes the point that each baptized Christian is united with Christ through the Holy Spirit, and the ascended Christ sends gifts of ministry on to the members. Each has gifts of ministry to offer to the whole body of Christ (Eph. 4.1–15). When the whole body of Christ is working properly, it results in growth and upbuilds itself in love. The corporate ministry of the Christian Church, in other words, is to express and work out the ministry of the ascended Christ. Or, as we put it, Christian pastoral ministry is to be caught up into the pastoral ministry of Jesus. It is worth noting four particular aspects of Jesus’ ministry of healing that are pertinent to our thinking about the Church’s contemporary pastoral ministry.

First, the healing ministry of Jesus proclaims God’s kingdom. When the deaf hear again, when the blind see again, when the paralysed walk again, and when the dead live again, the message is reinforced: God’s kingdom brings new hope where there is despair; new life where there is death, a renewal of health and well-being.

Again and again, Jesus breaks the rules. He touches a leper, even though leprosy made a person unclean. He touches the woman who has a discharge of blood, even though that was thought to be ritually unclean. He reaches out to the dead body of the son of the widow of Nain, even though touching the dead makes one unclean. God’s kingly rule in Jesus breaks down barriers of exclusion that prevent people hearing God’s welcome. It places the law in the richer, healing context of grace.

If the pastoral ministry of the Christian Church is to be caught up into the ministry of Jesus, it needs to be understood as part of the gracious work of God’s kingdom, bringing life to individuals, breaking down the barriers that stop people hearing God’s welcome.

Second, the healings of Jesus were community events. Usually they were in public – visible signs of God’s kingdom. When Bartimaeus is healed of his blindness,[8] Jesus faces him with his own responsibility and needs by asking: ‘What do you want me to do for you?’ Jesus hands responsibility and choice back to Bartimaeus. But everyone who is watching is confronted with the presence of God’s kingdom power – what does this mean for them? Is Jesus, perhaps, confronting the whole community with its blindness and responsibility and choice? In such healing events, society as a whole is called to the bar of God’s kingly rule.

A further social dimension to the healings of Jesus can be seen in his attitude to the demonic. As Jeffrey John makes clear, the New Testament uses the same terms ‘principalities and powers’ to refer both to supernatural forces, and also to ‘the very real powers – armies, nations, institutions, individuals – which represent them on earth . . . The freedom Jesus brings is freedom from both personal and systemic evil; his confrontation with the demons parallels and symbolizes his confrontation with the Jewish authorities. The relevance of this for us is that ‘the healing Jesus brings is as necessary for systems and societies as it is for individuals’.[9]

The pastoral ministry of the Christian Church, then, needs to be concerned not only with the individual, but with the whole society in which that person’s life story is set, and this takes us into political questions of community health, as well as questions of deliverance from ‘principalities and powers’.

Third, the healing ministry of Jesus changed people’s priorities. This is nicely illustrated in the story of Zacchaeus – the chief tax collector who had been economical with the truth.[10] After his encounter with Jesus, Zacchaeus promised to return goods to people whom he had defrauded, and his business priorities are turned around in the light of God’s rule. And Jesus said to him, ‘Today salvation has come to this house.’ Or, as William Tyndale’s translation has it, ‘Today, health has come to this house.’

If the pastoral ministry of the Christian Church is to be caught up into the ministry of Jesus, it needs to be concerned with lifestyle as well as with cure, with ethics as well as with feelings, with business as well as with private life. God’s kingly rule concerns all of life at all levels – as must the Church’s ministry.

Fourth, healing is linked to forgiveness. Four friends bring a paralysed man to Jesus and, because of the crowds, let him down through a hole in the ceiling.[11] Jesus first says, ‘Your sins are forgiven.’ Then later says, ‘Take up your bed and walk.’ The healing work of Jesus touches this person’s need for forgiveness as well as his hope to walk again.

Healing at all levels comes from God. This is beautifully expressed in the words of the prayer after communion in The Book of Common Prayer, which thanks God for ‘the forgiveness of our sins, and all other benefits of his passion’. Those ‘other benefits’ we can take to include the ministry of healing and wider pastoral care.

God, it seems, sometimes withholds healing at one level in order to heal us in other ways first. Sometimes we need to hear about the forgiveness of our sins before we can receive the other word about health for our bodies. Healing is a process: it doesn’t happen all at once. The theologian T. F. Torrance referred to ‘eschatological reserve’, by which I think he meant there is a gap between the word of forgiveness and the word of full healing. With this paralysed man, the gap was a few minutes; with some of us it takes a lifetime.

In the cross of Jesus, the word of forgiveness has been spoken, and in that sense there is healing in the cross: ‘By his wounds you have been healed.’[12] But the working out of that promise takes a life of growing into wholeness. God’s word of health comes to us sometimes just in part in this life, and in its fullness not until we reach the fullness of the kingdom. The Church’s ministry of healing – and indeed all our pastoral ministry – takes place in that gap between the presence of God’s kingdom in the life and death and resurrection of Jesus – with all the blessings that flow to us from that here and now – and the fullness of that kingdom in the life to come.

And it is that kingdom that is inaugurated in the resurrection of Jesus from the dead. The resurrection demonstrates the messianic hope that Jesus is the Messiah who brings shalom. It is an affirmation of creation and the beginning of its healing.

The resurrection is the resurrection of the body, which gives to our bodily life a value and meaning to be cherished. It established the victory of the cross, and provides the hope that one day there will be no more death, nor crying, nor pain. And it is the resurrection of Jesus that gives power to the Church’s pastoral ministry: the Church lives in the power of the Spirit given through the resurrection of Jesus.

Historical sketch

After New Testament times, there considerable evidence for a continuing charismatic healing ministry being exercised by the early Christian Church, and there are records of healing miracles during the first three centuries of the Church’s life.[13] There seem to have been close links between the Church and medical practice, but over time the Church’s healing ministry became more sacramental, combined with anointing and exorcisms. During the Middle Ages, around the eleventh and twelfth centuries, with the growth of monastic orders, there is a phase of records of miraculous healings, often through contact with the relics of saints. Despite caution from some church leaders, at the level of popular devotion much of the healing ministry of the Church was associated with magic at this time.

By the sixteenth century, at the time of the Reformation, many Christians attempted to take the magic out of religion.[14] Many believed that illness was sent by God, and that suffering was to be endured patiently. Neither of the great continental Reformers, Luther or Calvin, believed in miraculous physical healings, but concentrated on the miracle of the spiritual healing of the soul. The first Anglican prayer book of Thomas Cranmer, in 1549, provided an ‘Order for the Visitation of the Sick’, which included a long exhortation reminding the ill person that sickness is ‘God’s Visitation’, and that they should ‘take in good worthe the chastisement of the Lord: for whom the Lord loveth he chastiseth’. It concluded with a form of anointing with oil – anointing that was omitted from Cranmer’s second prayer book of 1552.

Since the Reformation, the split between Church and medical practice, fed by a dualistic view of human nature separating body from soul, has developed still further. During the seventeenth century, with the growth of the view of the world as a large machine, working according to Newton’s laws, there emerged a large split in some people’s minds between the physical world, which they believed could be understood by science and medicine, and the spiritual world, which was of concern to God. Medicine and religion tended to be kept in separate compartments. People went to the priest to confess their sins, and to the doctor for their physical health. More recently, and in the twentieth century in particular, with the founding of various Guilds of Health, the Church’s healing ministry has become more identified with the sacramental ministry, and the Church’s ministry of healing has become well established, clergy working alongside medical professionals in striving for the health of the ‘whole person’. In particular, the growth of the Pentecostal churches in the twentieth century, and of the charismatic movement within older Christian denominations, has brought ‘gifts of healing’ within the Church to greater prominence. In addition, the development of social and political dimensions to health within communities has been explored from a Christian perspective and implications drawn for the corporate and social aspects of the Church’s ministry to the sick.

Pastoral care today

If we understand the Church’s pastoral ministry in relation to questions of health to include the three aspects of ‘shepherding’ identified by Hiltner[15] (healing, sustaining and guiding), as well as co-operation with the medical profession, involvement in counselling and psychotherapy for those with emotional problems, the ministry of deliverance in relation to ‘principalities and powers’, and the social dimensions of community health, we can see that there is a considerable variety of Christian responses to questions of sickness and health. Each in their different ways can express something of the healing ministry of Jesus; each can proclaim God’s kingdom of shalom.

We can identify a number of primary models of Christian pastoral care in the Church today, each of which can relate to the ministry of healing:

Proclamation and teaching model

For some Christians, the primary task of Christian ministry is the proclamation of the gospel, often identified as expository preaching, teaching, and verbal evangelism. Certainly all the thousands who listened to Dr Lloyd-Jones preach in the 1960s at Westminster Chapel heard sermons that brought the text of Scripture in touch with people’s personal needs, and the word of God struck home in a life-changing and often healing way. There can be a very powerful pastoral theology of preaching, but there is also a danger of making this model the sum total of pastoral care. The preacher can hide defensively behind the expository mode, and preaching can become cerebral and didactic in a way that fails to meet people ‘where they are’. In the book of Job, Eliphaz, Bildad and Zophar in their different ways were no doubt excellent expositors, but they did not help to meet Job’s need: ‘Miserable comforters are you all!’[16]

Nurture model

Some patterns of discipleship – ranging from Wesley’s class meetings, to Christian summer camps – provide a Christian approach whereby young people in particular are nurtured and cared for by older like-minded Christians (a model that seems so attractive that the atheist camps supported by Richard Dawkins have taken it over). Fellowship groups, Bible studies, home groups and cell churches can all provide a context not only for worship and service, but for mutual support – sometimes even mutual therapy. This avoids the guru-mentality of the preaching model, but in some churches hierarchies of ‘shepherding’ and authority structures are developed that are not always liberating. There are variants on this model in the sort of support groups set up for survivors of abuse and, in a different way, groups aiming to enable sex offenders to be accountable when they return to the community.

Service model

By ‘service’ I mean pastoral ministry that is motivated by compassion and emphasizes the importance of social welfare, and also the political commitment to social justice concerning the environments in which people live. Many church groups and church institutions are involved in community health projects, as advocates for justice in health-care delivery and the social changes that promote healthy living.

There are organizations such as Welcare in Southwark Diocese, which ‘offers services to families to help improve the quality of their lives, and enables them to fulfil their potential’. There are working groups trying to implement the recommendations of Time for Action, the CTBI Report on survivors of abuse. There are also various global organizations ranging from Christian Aid to Jubilee 2000, which act politically against poverty out of the conviction that each person bears God’s image and has a right to certain basic necessities.

A further dimension to the service model is the Church’s concern with what has come to be called ‘community health’. This moves concern for health beyond a narrowly medical model, and recognizes dimensions to health that are more public and social. It is concerned with issues relating to the environment, to air pollution, to the availability of clean water, to matters concerning transport. Behind such concerns lies the Christian conviction that there needs to be equality of opportunity for access to the rich resources of God’s world, and an equitable distribution of the things that contribute towards good health. Alongside the Christian concern for individual health, therefore, some churches – inspired by the calling to live out the justice of God in all human affairs – develop local community links for the sharing of resources, are open to the needs of the wider world (particularly those parts that are the most poor and disadvantaged), and seek to contribute to policy-making at community level. Often the Church contributes to debates about education – clearly a key factor in the promotion of good community health – and the promotion of a healthy lifestyle.[17]

Therapy model