Orthodox Pastoral Care
Orthodox Pastoral Care
Orthodox Pastoral Care
The pastoral work of the Church is the continuation of Christ's ministry. Our
Lord Jesus Christ, who came among men to cure mainly the spiritual diseases, never
hesitated to ease the bodily infirmities, the diseases of all those who asked him to
and even those who did not. He never saw in these diseases a necessary pain and
thus He gave us an example of what our proper attitude should be against them. He
showed Himself to the people as a Doctor (Physician): “It is not the healthy who
need a doctor, but the sick”. (Mt, 9.12) In Him were fulfilled the prophecies of the
Old Testament about the Messiah, the Saviour of the human race: “Surely he took up
our infirmities and carried our sorrows, yet we considered him stricken by
God, smitten by him, and afflicted. But he was pierced for our transgressions, he was
crushed for our iniquities; the punishment that brought us peace was upon him, and
by his wounds we are healed”. (Isaiah 53, 4-5, Mt.8, 16-17)
In this regard, the Holy Fathers and the whole tradition of the Church take
care to present Him both as the "Doctor of bodies" and as the "Doctor of souls". This
healing power was then transmitted by ordination to the ecclesiastical hierarchy and
held on until the ages. However, Christ remains "the only Doctor" because, through
the apostles and saints, He is always the one who heals. Calling the twelve disciples,
Christ gave them His healing power. He makes them doctors in His likeness, giving
them command over the unclean spirits and casting them out (Mark 6.7, Luke 9,1),
as well as healing all sickness and all infirmity in people (Matthew 10,1.8 Luke 9,2).
Jesus Christ, the Risen One, who has all power in heaven and on earth, sends
the Apostles around the world before His Ascension (Mark 16 , 15) : "Therefore go
and make disciples of all nations, baptizing them in the name of the Father and of
the Son and of the Holy Spirit, and teaching them to obey everything I have
commanded you. And surely I am with you always, to the very end of the age."
(Matthew 28, 19-20).
With this reference He states the essential aspects of their mission, and thus of
the Church, in the world: preaching of the Gospel and teaching of the Word of God;
celebration of the Holy Sacraments (instituted by Himself) for imparting the
sanctifying Grace and preservation of the true faith for the sanctification of life, for
witness and for ministry. Preaching or ministry of the Word (Acts 6, 4), liturgical and
sacramental ministry and guidance should always be accompanied by diaconal
ministry (philanthropy) as a practical expression of love for God and neighbour;
faith and ministry must be seen and pursued as a whole, not separated.
In this regard, philanthropy is always part of the mission and ministry of the
Church. It is more than a simple ethical issue; it is a way through which we
encounter Christ, for He identifies Himself mysteriously in every man, especially
those in need and suffering "Truly I tell you, whatever you did for one of the least of
these brothers and sisters of mine, you did for me.." (Mt 25, 40). The Holy Fathers of
the Church saw in the love of neighbour, especially of the poor of all kinds, a second
altar, "the mystery of the brother", the place where the love for God is visibly
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exercised, for it is Christ hidden in the face of every sick, every poor and deprived of
love. “For I was hungry and you gave me something to eat, I was thirsty and you
gave me something to drink, I was a stranger and you invited me in, I needed
clothes and you clothed me, I was sick and you looked after me, I was in prison and
you came to visit me” (Matthew 25, 35). The “Mystery of the brother" is the Church's
practical attitude to man, wherein it contemplates, confesses, lives and deepens the
mystery of divine love for man or the mystery of the incarnation of God.
The Christian priesthood springs from Christ and thus is love and dedication,
full service to God and neighbours. A dedicated priest truly loves and lives self-
sacrifice continuously; relating himself to the measure of our Saviour, Who gave His
life "for us and for our salvation."
The priest, like the Good Shepherd – Christ, puts his life for his sheep, which
he loves and protects, because they have been entrusted to him and his essential care
is the salvation of the pastoral flock, toward eternal happiness. He has no peace and
quiet in his soul until there is peace and harmony among his parishioners and in the
soul of each of them. Saint Apostle Paul advices his disciple Timothy, and through
him, all of us, the clergy: “Do not neglect your gift, which was given you through
prophecy when the body of elders laid their hands on you”. (I Timothy 4, 14) His
main concern is finding the lost sheep stray from the herd and its return to the fold
of love.
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ceasing of wars and the end of any disorder, for peace, for prosperity and health; he
intervenes massively to remove or alleviate the effects of natural disasters such as:
droughts, floods, pestilence, earthquakes. Therefore, the Fathers of the Church easily
passed from prayer to earthly affairs and intervened to ease or eliminate social
shortcomings; St. John Chrysostom notes that the burden of the episcopate of his
time included the helping of widows and orphans, nursing and special care for
virgins, all these on a daily basis. This practice was a general characteristic of the
patristic church and its great people, such as the great Cappadocian Fathers,
especially St. Basil the Great, who organized charity institutions like hospitals,
retirement homes, orphanages, and schools for the education of the poor girls.
In all these activities, the model to follow remained Christ, the Great
Shepherd, who truly brings relief to various sufferings through His servants. “The
Spirit of the Lord is on me because he has anointed me to proclaim good news to the
poor. He has sent me to proclaim freedom for the prisoners and recovery of sight for
the blind, to set the oppressed free, to proclaim the year of the Lord’s favour.” (Is. 61,
1-2, Luke 4, 18-21) In this sense, St. Ambrose, Bishop of Mediolanum (4th century),
used to preach: "Christ is everything to us." This love for the Saviour has left us in
His will: "If you want to heal a wound, He is the physician; if you are weary, He is
the source; if you're crushed by injustice, He is right; If you need help, He is
strength; if you're afraid of death, He is life; if you want the sky, He is the way; if
you are in darkness, He is light. [...]. Taste and see that the Lord is good: blessed is
the man who put his trust in Him."
In today's life, when technical progress has given man such great
achievements, it has been observed that gradually he has more and more worries,
many of them consisting of new diseases, some of them incurable. Estranged from
God, closed into his ego and spiritually blind, man seeks only bodily healing
through chemo-therapeutic methods, which do not result in full recovery of health.
Life is the greatest gift that man received from God and it has its own laws given by
God and transmitted to us through the Revelation-Holy Scripture and Holy
Tradition. Whenever these laws are violated by men, the result is the desecrating of
life, and thus an imbalance occurs, which is the internal state of disease as a result of
sin.
The soul is the life of the body and the life of the soul is God. Only a body
united with its soul is alive and only a soul united with God is alive. For this reason,
“sacro- therapy” is a method of healing that addresses both the soul and the body in
order to restore health and return to real life, which man had before the fall of first
humans, Adam and Eve, the life without any affection. Therefore, disease therapy is
primarily the re-sacralisation of life, without which mere chemotherapy will be
unsuccessful. The cause of inner imbalance, sin, the reason why man was alienated
from the source of life - God, has to be eliminated. The wages of sin are death, says
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St. Apostle Paul to the Romans. If the soul-the life of the body- is not healed first,
then the body will be in a permanent imbalance, which will eventually lead to death.
According to our belief, illness, suffering and death are not natural human states,
they are the result of the sin of disobedience. That which man must eliminate in him,
in order to regain health and eternal life, is just the sin.
Paraphrasing the Russian theologian Evdokimov, any problem has as cause a
spiritual problem which eventually led to the removal of divine Grace. In our
orthodox theology, health means full harmony between soul and body and between
man and God. Therefore, any healing processes that address only the body have, for
this reason, few chances to succeed. Healing, in our vision, joins the human
universal desideratum in restoring health, but it necessarily also involves the
acceptance and completion of a process cause-effect (consequence) that is aimed
primarily at the spiritual healing that provides eternity through salvation and
secondly at the physical healing inasmuch as through it we are provided by God’s
Providence with more chances and time to reach harmony (reconciliation) with our
Creator, through repentance and holy Sacraments.
Christianity is a science that heals inasmuch as theology is not a philosophy
but a psychotherapeutic system. At this point I find this account from the
Metropolitan Hierotheos of Nafpaktos in his book “Orthodox Psychotherapy”
relevant: “Many people interpreting the character of Christianity see it as one of the
numerous philosophies and religions known from antiquity. Certainly Christianity
is not a philosophy in the sense that prevails today. Philosophy sets up a system of
thought which in most cases bears no relationship to life. The main difference
between Christianity and philosophy is that the latter is human thinking, whereas
Christianity is a revelation of God. It is not a discovery by man but a revelation by
God Himself to man. It was impossible for the human mind to find the truths of
Christianity...” Beyond all other interpretations, Orthodoxy is mainly a therapeutic
science and treatment. It clearly differs from other psychiatric methods, because it is
not anthropocentric but theo (divino)-centric and because it does not do its work
with human methods, but with the help and energy of divine Grace, essentially
through the synergy of divine and human volition.
Theology is both the result of therapy and the correcting guide to it. Theology
is the fruit of psychotherapy and its methodology. It is not an intellectual discipline
but the fruit of human healing of the passions. In other words, only those who were
healed and have reached communion with God can be called theologians and only
they can guide other Christians on the path which leads to the “place of healing”-
the Church.
The word psychotherapy is composed of two words – ψυχή (soul, mind) and
θεραπεία (therapy, healing). The soul in question is not something abstract or
autonomic, but the so-called spiritual element of human existence which was created
by God. Therefore, the therapy of the soul is actually both the acquiring of the Holy
Spirit and its fruit as well. According to the Church Fathers, as the body without
soul dies, so the soul, when it is deprived of the Holy Spirit, is dead. Thus,
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psychotherapy is the therapeutic process by which man achieves communion and
union with God. Orthodox Psychotherapy provides the methods of spiritual healing-
the holy Sacraments.
As big the difference between human wisdom and divine wisdom is, so great
is the difference between human and Orthodox psychotherapy. The foundation of
Orthodox spirituality and psychotherapy lies in the unique event of the Incarnation
of the Son of God, who by this act assumes human nature in its entirety but sin,
which He then through Himself heals throughout the entire process of redemption.
St. Athanasios, bishop of Alexandria (4th century) states that “God became man for
man to become God.”
Priesthood as a “science of healing of souls”, a term used by St. Gregory
Palamas (14th century), “aims to wing the soul, to transfer it from the world and to
give it to God, to make it to keep the image of God, if it hasn’t lost it already, and if it
is in the distress to lose it, to show the way and to keep it; and if it is broken, to bring
it back to the first state”. Priesthood intends, through the Holy Spirit, to bring Christ
to live together in the hearts of believers. The most important purpose of priesthood
is to make man God in grace and thus attain eternal happiness. The value of
priesthood lays in that it helps the believer to move from the stage of “image” of
God to that of “likeness” of God. Leading them towards deification, priesthood in
the Church actually leads to healing - for deification is healing and perfection.
God made man in His image and so he is alive because God is alive. If God, as
we are told by Christ, is the God of Abraham, Isaac and Jacob, that means they are
not dead. For God all humans are alive. God created man healthy, "And God saw
everything that he had made and behold it was very good" (Genesis 1, 31). This
means that He didn’t create him mortal. Immortality was a potential condition
which was linked to his deification. And this because he was created in order for
"the uncreated divine energies to penetrate every member in part and thus to
transfigure and deify him." In relation with the primordial state of man, St. Basil the
Great remarks that "They (humans) were free from any disease (...) for the gifts the
man received from creation."
The disobedience sin of our forefathers Adam and Eve had as an immediate
effect the loss of holy Grace, so we lost the divine protective garment and passed
into this fleeting and perishable world, being condemned to live a life that is prey
(object) to many evils and misfortunes, and afterwards death. Since then, the health
of the body, for any man, cannot be a good definitively acquired; it never exists
absolutely and in fact is nothing more than a partial and provisional balance, a state
of less disease. St. Maximus the Confessor notes: "A well-ordered life is the cause of
health" while the “spiritual unrests inevitably are translated in soul and body by
pathological disorders”. In the Old Testament, God made Himself very clear: “If you
listen carefully to the Lord your God and do what is right in His eyes, if you pay
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attention to His commands and keep all His decrees, I will not bring on you any of
the diseases I brought on the Egyptians, for I am the Lord, who heals you.”(Exodus
15, 26)
According to our faith, a sinner is in a state of slavery. From the lesson
delivered by our Lord to the paralytic: "See, you are well again. Stop sinning or
something worse may happen to you." (John 5:14), we know that the cause of illness
is actually our sins and thus, the cure against it is not only in the drops prescribed by
doctors, but also in the drops flowing from a broken and repented heart. Therefore,
we can deduce that the free man is actually that who obeys God, because only He
can make him free and release him from the bondage of sin, which is difficult for
both the soul and the body, because sin produces illness for both of them. Moreover,
modern medicine stresses the consequential link between all kind of abuses and
moral deviations which affect contemporary society and the general health state.
At this point we have to state something. In different Christian circles the
punitive concept of suffering has been discussed a lot, which is totally foreign to the
Orthodox faith. If we would sustain this, it will be the same with the denial of God's
love for man. However, we have to perceive death as the natural consequence of
separation from God, which man has chosen freely. For this purpose we define
death as the absence of life. Life, indeed, was a promise, but a promise that could
only be fulfilled through participation in divine life through union with God. This
was the symbol of the tree of life planted in the middle of the garden Eden (Genesis
2, 9) and which was given to man as an exercise of free will. “And the Lord God
commanded the man, “You are free to eat from any tree in the garden; but you must
not eat from the tree of the knowledge of good and evil, for when you eat from it
you will certainly die.” (Genesis, 2, 16-17)
In spiritual terms, health, according to Church Fathers, is one of the "middle",
neutral things, which by themselves are neither good nor bad, but "according to the
disposal of those who use them, and can be used for good or evil." (St. John Cassian,
4th century). It is true, physical health corresponds to the original and normal
condition of human nature, the paradisiacal one, and for this reason it can be
considered a good by itself, as we are taught by the great martyr of the Church, St.
Maximus the Confessor. Yet, on the other hand, it serves nothing to man and does
not constitute for him a real good if it is not used beneficially. If health is not used in
the service of good, man remains just "flesh" ( Jn. 6, 63) and does not use the body, as
a “temple of the holy Spirit”(1 Cor. 6,19) in order to fulfil the commandments of
Christ and thus praise God.
In this perspective, St. Basil the Great writes: "The health as one that by itself
does not make good all those who experience it, is not among the good things by
their very nature". Even more, it may become an evil since it serves man to commit
sin or to seek satisfactions in all kind of evil passions.
Furthermore, the Church Fathers, while considering disease a bad thing, a
consequence of Adam's sin and the devil’s work in a world subdued to sin, the
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opposite of the initial order willed by God when He created the world and man, they
still reckon that disease is a bad limited only to the physical nature, of the body.
If man does not indulge in sin at the time of the disease and does not get
distant from God because of it, then, spiritually, the disease cannot be considered an
evil for him. "If the soul is healthy, the physical disease may not cause any damage
on human" writes St. John Chrysostom. Therefore it is evil - he says with other holy
Fathers- only in appearance; it may be even good for humans, since, using it wisely,
they may acquire spiritual benefits, turning it into an instrument of salvation which
initially was the sign of their destruction. In fact, this is how God works upon us,
turning all the afflictions we are confronted with into our benefit. “Come to me, all
you who are weary and burdened, and I will give you rest” (Matthew 11, 28). Thus,
St. Gregory of Nazianzus urges: "Do not boast any health and do not hate any
disease."
In some cases, viewed from the perspective of what is good in spiritual terms,
disease can be seen, paradoxically, as a greater good than health itself and even
desirable, as we are shown in the life experiences of all those who for their struggles
and victory, God revealed to us as saints. St. Gregory of Nazianzus said that the
purpose of medical treatment "is healing and good condition of the body; and, (that)
once found, their maintenance...but it is not clear-he adds, if their acquisition is
always helpful. Because often hostile conditions bring more gain to those who
endure them by the end."
It is natural that we should prefer health, but only on the condition that it is
lived in God and for God and one’s neighbours. According to our orthodox
theology, the recovery from illness has a sense only in relation with the ultimate goal
of man, the salvation of his whole being, which is possible only through the victory
over sin.
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their eminent end, considering the prayers of the priest or, especially, receiving Holy
Communion as the last step before death, and they often refuse help, and the third
are those who, while awaiting healing, do not show any direct personal
involvement, but rather expect it from others, doctors and priests.
However, we understand that the patient is in a difficult position, facing a
new situation, a crisis. Disease itself is one of the most serious crises, because it puts
man in front of a number of issues that, as long as he was healthy, he was not
thinking about. Now tact and communication skills are required so that the patient
might open themself before the priest. This is a very important moment.
Approaching the sick is a work of great spiritual fineness, which requires not only
knowledge but rather deep wisdom, great humility, true love for people and desire
to serve Christ, mystically present in the face of the patient. When the priest goes to
the bedside of the sick, he must show that the patient is the most important person
and that he is there just for him.
At this point, the advice of Metropolitan Anthony of Sourozh (with a vast
experience as a doctor during the 2nd World War) is relevant: " If you go to stay at
the bedside of a sick and you have only five minutes, it is clear that these minutes
belong exclusively to him, that during these five minutes or more, your thoughts
will not be dealing with anything else and no one else in the whole world is more
important than the one with whom you are. On the other hand, silence is very
important too. Stop chatter, leaving instead a profound silence, attentive, full of a
warm caring. It's not easy to learn to remain silent. Sit down, take his hand and tell
the patient quietly: " I'm glad I'm with you ..." Then keep a moment of silence. Be
present without a lot of insignificant words or superficial emotions. Let your visit
bring to the patient joy and conviction that you enjoy it. Prove your tact and courage,
this is what is required to encourage the patient to tell his fears, because one of the
things most burdensome for him is to lay flat in bed, locked in a solitude born from
the inability to speak. A large number of people, thinking they are affected by an
incurable disease, do not dare to put questions for the fear of a response . The first
visit of a patient can be the beginning of a relationship based on honesty”.
The greatest help that the priest could offer is lifting the patient on the arms of
his prayer in front of the “Healer of bodies and souls” which is Christ, both in
liturgical, common prayer, and in his private, personal prayer. It is recommended as
well that the priest involve the relatives and his friends, even the entire parish
community to increase their prayers, corroborated with fasting for him, as otherwise
is required in the Holy Scripture, " pray for each other so that you may be healed"
(James 5, 16). Thus, we can better realize our membership, as members of the
mystical body of Christ-the Church for "If one part suffers, every part suffers with it;
if one part is honoured, every part rejoices with it." (1 Cor. 12, 26)
Of course, only our prayer is not enough. In order to get them healed, God
asks from them just one thing- to pray with faith: “If you believe, you will receive
whatever you ask for in prayer.” (Matthew, 21,22)
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This is the moment that the patient realizes that, while, being helpless and
even hopeless; there is HOPE from the HEALER. Both Healer and Healing are
special-Jesus Christ and His Cross transcending the pain and death through
Resurrection. Most of the times the disease is a heavy cross but as long as the patient
carries up his cross, the disease is beneficial for they are not alone, they are
accompanied and supported by Jesus and thus, we know our destination:
Resurrection and Salvation. Moreover, there is no Easter without Good Friday.
Saint Kyrillos of Alexandria noted that in Hebrew the name Jesus means
Saviour and in Greek, it means Healer. He says: “Jesus heals the eyes of blinds and
enlightens the minds as well. He is the Doctor of the lames and He strengthens the
feet of sinners toward repentance”. It is not random that in the Greek language, the
term used for salvation-«σωτηρία» means healing as well and in Latin the word
salus, salutis means both health and salvation. So, Salvation and Health! These are
the things the Church prays most for. These are the Gifts of the Holy Trinity, which
the Church, through the Holy Grace, the uncreated divine power, provides us with-
The Holy Sacraments. These are administrated by the priests “as faithful stewards of
God’s grace” (1 Peter 4,10) and “As servants of Christ and as those entrusted with
the mysteries God has revealed” (I Cor. 4,1). All the Sacraments of the Church are a
real “spiritual pharmacy” with the greatest of them, the Holy Communion, the par
excellence MEDICINE of Salvation. The Sacrament of Unction shows us through its
prayers the link between sins and sufferings. The ultimate response of the Church
for her sick sons is the forgiveness and conciliation with Christ. The greatest and the
most important miracle is Forgiveness. This is why the Holy Unction is always
related to repentance, confession, Liturgy and Holy Communion- union with Christ.
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the sun of His glory shine upon all. (Mt. 5, 45 ). In healing, as in illness, man should
not lose from his sight his ultimate goal, which is the final salvation of his whole
being, soul and body, in Jesus Christ. Only through a relationship with Christ, the
only Man in history who said about Himself “I am the way, the truth, the life” (John,
14,6), humans get the answer to the existential questions which preoccupy the
world, “who are we and where do we go?”. And our way is the way of our Lord
Jesus Christ, Human and God, “the first born of the dead”, the way of resurrection
(as we are going through the paschal period), of the empty tomb. The way of Life
and The Light, “I am the light of the world. Whoever follows me will never walk in
darkness, but will have the light of life.” (John, 8,12). This path leads us through
Resurrection to our eternal parental home in Heaven, “For here we do not have an
enduring city, but we are looking for the city that is to come” (Hebrews, 13,14). Only
this can explain something common to us, Christians, while for others it is an
unexplained and surprising phenomenon-the courage and smile on the face of a
brother or sister confronting the end. For us this is just the certainty and pace
achieved by the reconciliation with themself and God.
Christ is Risen!
Selected Bibliography
Mitropolit Antonie de Suroj, Viața, boala, moartea, Traducere din limbile engleză şi
franceză de Monahia Anastasia (Igiroşanu), Editura Sfântul Siluan, Slatina-Nera,
2010
Pr. Prof. Dr. John Breck, Darul sacru al vieţii, Editura Patmos, Cluj-Napoca, 2001
Pr. prof. dr. Ion Bria, Curs de Teologie şi practică misionară ortodoxă,Geneva, 1982
Dr. Pavel Chirilă, Conceptul de medicină creştină – Sfânta Scriptură citită de un
medic ortodox, Editura Christiana, Bucureşti, 2001
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Mitropolit dr. Daniel Ciobotea, Taina fratelui, în „Candela Moldovei”, an III, nr. 1-2,
1992
Fr. Stanley S. Harakas Health and Medicine in the Eastern Orthodox Tradition
www.goarch.org/en/ourfaith/articles/article8076.asp
Sfântul Ioan Gură de Aur, „Despre preoţie”, Ed. Ins. Biblic şi de Misiune al BOR,
Buc., 1998, trad. de pr. D. Fecioru, cartea a III-a, cap 10
http://www.pantocrator.ro/jean-claude-larchet-boala-este-si-rea-si-buna
Jean –Claude Larchet, Creştinul în faţa bolii suferinţei şi morţii, traducere din limba
franceză de Marinela Bojin, Bucureşti, Editura Sophia, 2004
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Ioan C. Tesu Pr. lect. univ. dr., Preotul – chip al iubirii si dãruirii depline, in rev.
TEOLOGIA, an IV, nr. 1, 2001, p. 74.
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