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
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