Anointing the Sick: A Parish Sacrament

by Thomas Richstatter, O.F.M., Th.D.

Have you ever been seriously ill? Have you ever been anointed during a celebration of the Sacrament of the Anointing of the Sick? If you answered yes to the first question, I hope you answered yes to the second also. When the Sacrament of the Anointing of the Sick becomes a more normal part of Catholic experience the primary thrust of the Second Vatican Council's renewal of the sacrament will have been achieved.

The revision's intent, said Pope Paul VI in 1975, was "to lead to a wider availability of the sacrament and to extend it—within reasonable limits—even beyond cases of mortal illness."

Jesus, sacrament of healing

Our mission as Church is to do what Jesus did. And on nearly every page of the Gospels we read of Jesus' concern for the sick. Healing was essential to the mission of the disciples: "He summoned the Twelve and began to send them out two by two.... They anointed with oil many who were sick and cured them" (see Mark 6:7-13). After Jesus ascended into heaven, the Church continued to be a sacrament of healing: "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 the sick, and the Lord will raise them up; and anyone who has committed sins will be forgiven" (James 5: 14-15).

In the course of time, the focus of the sacrament shifted from healing to forgiveness of sins and the time for receiving the sacrament was delayed to the deathbed when forgiveness of sins would also be the final preparation for heaven. "Over the centuries the Anointing of the Sick was conferred more and more exclusively on those at the point of death. Because of this it received the name 'Extreme Unction" (Catechism of the Catholic Church, #1512). The Sacrament of the Sick had become the Last Anointing, the unction in extremis.

The Second Vatican Council wanted to remedy this situation. The Council reminded us that "the liturgy is made up of immutable elements, divinely instituted, and of elements subject to change. These not only may but ought to be changed with the passage of time if they have suffered from the intrusion of anything out of harmony with the inner nature of the liturgy" (Constitution on the Sacred Liturgy, #21). This was the case with Extreme Unction.

The Second Vatican Council placed the sacrament once again in the context of mutual prayer and concern described in the Epistle of James. Anointing "is not a sacrament for those only who are at the point of death" (Liturgy, #73) but is intended for all those who are seriously ill. Consequently, what we formerly called "Extreme Unction" is now more properly called "The Sacrament of the Anointing of the Sick" (see #73).

More has changed than the sacrament's name. Our experience of the revised Sacrament of the Anointing has brought about a change in the way we think about the sacrament. For example: 1) This sacrament (like all sacraments) is a community celebration; 2) sickness involves more than bodily illness; and 3) anointing heals us through faith.

Sacraments are community celebrations

The practice of administering Extreme Unction to those who were at the point of death brought with it a certain privatization of the sacrament. While we have become accustomed to the sacrament's new name, many Catholics still think of it as a private sacrament, administered by a priest to a single individual.

If I asked you to close your eyes and picture the Sacrament of Anointing, what image would come to your mind? I think many Catholics would picture a priest standing at a hospital bedside. For an increasing number of Catholics, however, the mental picture would be different. They would picture a parish gathered for Sunday Eucharist, with 30 or so people—some visibly ill, some apparently perfectly healthy—coming up the aisle to be anointed, some with their spouses or caregivers.

That public, communal sacrament is the sacrament celebrated to its fullest. One of the general principles of the Council's renewal of Catholic worship states: "Liturgical services are not private functions, but are celebrations belonging to the Church....Therefore liturgical services involve the whole Body of the Church; they manifest it and have effects upon it;…..Whenever rites...make provision for communal celebration involving the presence and active participation of the faithful, it is to be stressed that this way of celebrating them is to be preferred, as far as possible, to a celebration that is individual and, so to speak, private" (Liturgy, #26-27).

We are gradually experiencing this change among other sacraments, too. I can remember priests often saying their private Mass at the side altars of the parish church where I served Mass as a child. Today side altars have disappeared from our churches as we have come to see Eucharist as a community celebration. The Baptism of adult converts at the Easter Vigil has become public in a way and to an extent I would never have imagined before the Council!

Even the Baptism of infants is more and more frequently being celebrated publicly, during Sunday Eucharist. The sacrament is not only for the good of the infant, it is a grace to the whole parish. The child held in the arms of its loving father or mother is an effective sign of who we are before God. "Amen, I say to you, whoever does not accept the kingdom of God like a child will not enter it" (Luke 18:17). The celebration of the Sacrament of Matrimony gives grace not only to the couple getting married; their love for one another is a sign and sacrament of God's faithful love for us. Their commitment strengthens ours.

We are coming to see the Sacrament of the Anointing of the Sick in a similar fashion: "By the sacred anointing of the sick and the prayer of priests the entire Church commends the sick to the suffering and glorified Lord, asking that he lighten their suffering and save them (see James 5:14-16); the Church exhorts them, moreover, to contribute to the welfare of the whole people of God by associating themselves freely with Christ's passion and death (see Romans 8:17; Colossians 1:24; 2 Timothy 2:11-12; 1 Peter 4:13)" (Church, #11).

The Catechism of the Catholic Church states that when the sick are anointed they should be "assisted by their pastor and the whole ecclesial community, which is invited to surround the sick in a special way through their prayers and fraternal attention" (#1516). "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" (#1517).

More and more parishes today are scheduling celebrations of the Sacrament of the Anointing of the Sick within the community Eucharist. Pastors have told me that these communal celebrations educate the parish about the meaning of the sacrament and help to break down some of the fear that still remains from the days of Extreme Unction. These celebrations speak eloquently about key themes of Christian life: mortality, vocation, responsibility, limits, suffering, care-giving. Communal celebration of healing and trusting in God speaks loudly to a society which stresses individual responsibilities and tends to avoid discussing limits and mortality.

Healing body, soul and spirit

When I first learned about Extreme Unction and about how sick one would have to be in order to be anointed, I thought of "sickness" exclusively in terms of bodily illness. I never thought that there might be serious illnesses whose principal causes or manifestations were not physical. Nor did I realize as I do now the holistic unity of body, soul and spirit.

I should have known. For years I suffered from a colon disorder which the doctors said was caused by my unreasonable desire to make straight A's in every possible subject in school. That experience alone should have made me aware of the intimate relation of mind and body, but I never thought of "perfectionism" as a disease. Nor did I think of alcoholism as a disease; and I never even heard of codependency (a description of unhealthy relationships in a family affected by addiction). I was unaware of the way in which the actions of one member of a family can cause serious physical, mental and spiritual illness in other members of the family.

Today one does not have to be a doctor to know that physical health is related to mental and spiritual health. We all know how a divorce can cause ulcers; how being overworked and run-down can make one more susceptible to the flu. Often a person who decides to withdraw from an addiction experiences not only physical pain but also suffers from anxiety and depression. Mothers have told me of how, after the physical trauma of childbirth, the joy of having a baby can be completely covered over by the hormonally induced postpartum depression that sometimes follows.

Today we are all aware that tensions, fear and anxiety about the future affect not only our mind but our body as well. These illnesses can be serious. They can move us to ask for the healing touch of Christ in the Sacrament of Anointing.

Persons with the disease of alcoholism or persons suffering from other addictions can be anointed. So can those who suffer from various mental disorders. The anxiety before exploratory surgery to determine if cancer is present is a situation in which Christ's power can be invoked in the sacrament. Often the spouse or the principal caregiver of the person who is seriously ill also asks to be anointed when he or she, too, is seriously affected by the illness—the debilitating fear of an elderly husband ("How will I be able to live if she dies?"); the anguish of young parents whose child is dying ("How can a just and loving God allow this to happen?").

Our pastoral experience of the revised rite and the Church's desire for wider availability of the sacrament has helped pastors realize that serious mental and spiritual illnesses are also opportunities to celebrate this sacrament.

In these cases the person does not have to wait until the illness is so grave that he or she is in the hospital or institutionalized to celebrate the sacrament. Sacraments, after all, are community celebrations. It is preferable to celebrate them in the context of family and parish even before going to the hospital. The sick person has a better opportunity to appreciate the prayers and symbols of the rite when in her or his customary worshiping community.

There are times when old age and the fears and isolation that can sometimes accompany it need to be brought to the healing and comforting touch of Christ in this sacrament. It is a powerful sign for a parish community to see their senior members place their limitations and dependence in the hands of Christ, who accepted human limitation and freely embraced suffering and even death itself.

The Anointing of the Sick is a different kind of healing than a chemical placed into our body as medicine or a surgical intervention to cut out diseased tissue. Sacraments are acts of faith; they grace the whole person—body, soul and spirit. The blessing over the oil for anointing asks God to "send the power of your Holy Spirit, the Consoler, into this precious oil. Make this oil a remedy for all who are anointed with it; heal them in body, in soul and in spirit, and deliver them from every affliction" (Pastoral Care of the Sick, #123).

What gets healed?

Does it work? Will I experience healing? These are the questions that I am most frequently asked regarding the Sacrament of Anointing. And I always answer by saying yes. In my experience with this sacrament as a priest, healing always takes place. That healing, of course, is not restricted to mere physical healing.

When our attention is directed toward physical illness, it is natural to think of the effects of the sacrament in terms of physical healing. Sacraments, however, are celebrations of faith, expressions of who we are before God. This understanding of sacrament, together with the realization that we are more than our physical body, has led us to look again at the effects of the Sacrament of Anointing.

The Second Vatican Council has reminded us: "The purpose of the sacraments is to make people holy, to build up the Body of Christ and finally to give worship to God" (Liturgy, #59). The Sacrament of the Anointing of the Sick accomplishes this by helping us gain insight into the religious meaning of human suffering.

A quote from the General Introduction to the ritual itself, Pastoral Care of the Sick, explains more: "Suffering and illness have always been among the greatest problems that trouble the human spirit. Christians feel and experience pain as do all other people; yet their faith helps them to grasp more deeply the mystery of suffering and to bear their pain with greater courage. From Christ's words they know that sickness has meaning and value for their own salvation and the salvation of the world. They also know that Christ, who during his life often visited and healed the sick, loves them in their illness" (#1).

The celebration of the sacrament does not explain human suffering; sacraments are more than mere words of explanation. The sacraments celebrate faith. In the very celebrating we experience more and more who we are and what we believe. As the Catechism says, "Christ invites his disciples to follow him by taking up their cross in their turn. By following him they acquire a new outlook on illness and the sick" (#1506).

What does this new outlook involve? It helps us understand what St. Paul meant when he said: "Now I rejoice in my sufferings for your sake, and in my flesh I am filling up what is lacking in the afflictions of Christ on behalf of his body, which is the church..." (Col 1:24).

It also sheds light on what St. Paul says in 2 Corinthians: " '[P]ower is made perfect in weakness.' I will rather boast most gladly of my weaknesses, in order that the power of Christ may dwell with me" (12:9). In the sacrament, the sick come to see that "Jesus associates them with his own life of poverty and service. He makes them share in his ministry of compassion and healing" (Catechism, #1506).

In the sacrament we pray that the sick be healed in body, in soul and in spirit. God alone knows what kind of healing the sick need most: that a wound be healed; that a fear turn to confidence; that loneliness be embraced by the support of a praying community; that confusion in the face of all the whys—why me, why suffering, why now—turn to insight.

The Sacrament of Anointing does not remove the mystery of human suffering. Yet its celebration gives us a window into the mystery of a loving God. Our loving God raises up the crucified Son to display his victorious wounds, sitting triumphant at the Father's right hand.



What Does Communal Celebration Look Like?

1. The Mass begins as usual. There is a welcome and then special prayers for those to be anointed. Depending on the liturgical season, the readings are from the Sunday or from the special Lectionary provided for these Masses.

2. After the homily, there is a litany of prayers for those who will be anointed and for those who care for them.

3. The sick then come to the altar. There the priest lays his hands on the head of the person to be anointed, recalling Jesus' own usual manner of healing: "At sunset, all who had people sick with various diseases brought them to him. He laid his hands on each of them and cured them" (Luke 4:40).

4. Oil is brought to the altar. A prayer is said over the oil.

5. The priest makes the Sign of the Cross with the blessed oil on the sick person's forehead, saying: "Through this holy anointing may the Lord in his love and mercy help you with the grace of the Holy Spirit." All respond: "Amen." Then the priest anoints the palms of the sick one's hands with the Sign of the Cross: " May the Lord who frees you from sin save you and raise you up." All respond: "Amen."

6. Bread and wine are brought to the eucharistic table, and Mass continues as usual.




Anointing in a Home or Hospital

1. The rite begins with the Sign of the Cross with blessed water which reminds us of our baptismal promise to die with Christ so that we might rise to new life with him.

2. The readings from Scripture are adapted to the condition of the sick person. The priest prays and assures the sick person of the prayers of the parish and invites the sick person to pray for the needs of his or her fellow parishioners.

3. The priest imposes hands on the head of the one to be anointed, prays over the oil and anoints the forehead and hands of the sick person.

4. The priest prays for the sick person and invites all present to pray The Lord's Prayer.

5. Holy Communion may be received at this time.

6. The priest then blesses the sick person and all present.


Thomas Richstatter, O.F.M., Th.D., has a doctorate in liturgy and sacramental theology from the Institut Catholique of Paris. A popular writer and lecturer; Father Richstatter teaches courses on the sacraments at St. Meinrad (Indiana) School of Theology. His latest book isThe Sacraments: How Catholics Pray (St. Anthony Messenger Press).