Editor’s note: The purpose of this series is to walk our readers through James in order to help them understand what it teaches and how to apply it to our lives. This series is part of our larger commitment to help Christians learn to read, interpret, reflect, and apply the Bible to their own lives.

James 5:13, “Is any one of you in trouble? He should pray. Is anyone happy? Let him sing songs of praise.”

Healing in James

The topic of healing seems to arise abruptly in James, but it fits perfectly with the themes of chapters 4 and 5. You will recall that James promises grace to those who embrace gospel humility. “Humble yourselves before the Lord, and he will lift you up” (James 4:10). In the next section, James warns of three sins against humility: slander (James 4:11–12), presumptuous planning for riches (James 4:13–17), and abuse of wealth and power (James 5:1–6). Next, James proposes three antidotes to arrogance. Each reverses one of the sins of pride. James lists them in chiastic order.

We must not slander and judge our brothers (James 4:11–12).

We do not plan presumptuously (James 4:13–17).

The rich must not exploit the poor (James 5:1–6).

If the rich exploit us, we wait until the Lord, the Judge, comes (James 5:7–12).

We do not make proud plans, but take our joys and sorrows to God (James 5:13–18).

If our brother sins, we don’t slander; we correct and restore him (James 5:19–20).

So then, prayers for healing are part of the life of gospel humility. Yet James wants to do more than oppose arrogance one more time. He tells the church to pray in every setting of life, to take every concern to our Sovereign Lord. As James says: “Is any one of you in trouble? He should pray. Is anyone happy? Let him sing songs of praise” (James 5:13) Paul also summons Christians to pray in all circumstances (Eph. 6:18; 1 Thess. 5:17–18). James develops the idea by giving directions for four situations:

  1. If anyone suffers hardship, let him pray.
  2. If anyone is in good spirits, let him praise.
  3. If anyone is sick, let him call elders.
  4. If someone calls the elders, let them pray.

James 5 also describes various groups of people and when they pray. Individuals pray for joys and sorrows (James 5:13–14), elders pray over sickness (James 5:14–15), friends pray over sins they’ve committed (James 5:16), and prophets pray in time of need (James 5:17–18). Whatever our condition, whatever the circumstance, we should take it to the Lord in prayer.

Prayer in James

Believers pray. If we face illness or loss, we pray, lest we rebel against God. If we meet with success, we praise God, lest we give ourselves credit. Through prayer, we hallow every pleasure and sanctify every pain.

James’s main concern is prayer in times of trouble, but we must notice his interest in prayer during good times. If anyone is happy, James exhorts, “let him sing songs of praise.” Sing, James says. We should learn Christian songs, new and old—songs that speak to the heart and express its joys and yearnings. Use songs to rejoice in God’s blessings. Praise God for his salvation, for his gifts, for his daily providence. By stating the command in the present tense, James implies that such prayer is an element of daily life.

Christian musicians ought to write songs that enable believers to take every joy and sorrow to God. Christian music rightly focuses on worship and praise, and each generation rightly desires to express its faith in its own “songs of praise.” In standard hymnals, quite a few hymns praise God for deliverance from storms at sea. Today, we feel the wrath of storms in automobiles and airplanes. It seems, then, that we need songs that praise God in terms that match the means of transport in our day. Contemporary songs, therefore, should praise God for deliverance in language that features planes and cars, not to mention computers and the panoply of contemporary electronic devices. Christian musicians serve Christ well by writing new music for praise.

Christians should praise God, whether in song or in prayer, for every blessing, for food and shelter, for work and for play. In a Christian home, if one child stars in a school musical, if another excels in a soccer match, if father gets a promotion at work, if mother completes a painting, they must take their joys to the Lord. It would bless them if they knew songs that helped them consecrate their blessings to the Lord, instead of succumbing to pride. This way, we sanctify pleasures and consecrate pains. Whatever happens, we go to God in prayer. If happy, we praise (James 5:13b). If troubled, we pray (James 5:13a). If suffering and weak, we pray with the church elders (James 5:14a).

Sickness, Healing, and the Elders

We have lingered over James’s interest in joy. We could also linger over his broader point: everyone who suffers should pray. Here we glance back at James’s ongoing interest in perseverance. Christians endure trials (James 1:2–4); we suffer oppression, illness, disasters, and perhaps even persecution (James 5:1–10).

James begins, “Is any one of you sick? He should call the elders of the church to pray over him and anoint him” (James 5:14). This shows that James’s primary focus is prayer for physical needs. The word he chooses for “sick” literally means “weak.” If the context makes it clear, the term can refer to spiritual or mental weakness (Rom. 5:6; 6:19; cf. 4:19) or even a troubled conscience (Rom. 14:1–2; 1 Cor. 8:7–10). Certainly, chronic physical illness can afflict the spirit. Yet James chiefly refers to the sick who need physical healing (James 5:16).

The sick shall call the elders. Elders are the permanent local leaders of the church. The Jerusalem church had elders who served under the apostles (Acts 15:2–6, 22–23). Paul appointed elders to oversee the churches he planted (Acts 14:23; 20:17–28). They continued Paul’s work, overseeing his churches in his absence (Acts 20:28–32).

The apostles commissioned elders to watch the flock. Peter tells elders to “be shepherds of God’s flock that is under your care, serving as overseers” (1 Peter 5:2). As shepherds, elders come alongside the people to serve. As overseers, they know the needs of the people better than they know themselves. Yet, above all, an elder is to be an example of godliness and faith (1 Tim. 3:2–3; 1 Peter 5:3).

Sick men and women call the elders as a group. They do not call those with a gift for healing; rather they call all to pray for healing. James says the prayers of a righteous man are effective. Since the first qualification for an elder is holiness—not social standing or theological acumen—the prayers of elders are effective. The elders pray for healing, not for miracles. It doesn’t matter if a healing is quiet or splashy. True healings garner all the attention they need.

Anointing with Oil

The elders anoint the sick with oil. The disciples used oil in their healing ministry at least once (Mark 6:13), but neither James nor Mark explains the purpose of the anointing. Several views of the anointing with oil have arisen in Christian thought. First, we must decide if the anointing is medical or spiritual in nature.

The anointing cannot be purely medicinal. Oil was used medicinally on rare occasions (Luke 10:34), and the apostles are no foes of medical treatment (Paul urged Timothy to take wine for his stomach in 1 Tim. 5:23). But the call to the elders and to prayers shows that the purpose is not primarily medical. Finally, even if oil helped some maladies, no one thought oil healed every illness.

More likely, the anointing stimulated the faith of the sick person. Jesus sometimes called the sick aside for private conversation and touched them before healing them (Matt. 8:3; 20:34). Once, before healing a deaf and mute man, he put his fingers on his ears, spat, and touched his saliva to the man’s tongue (Mark 7:31–37). In that day, some believed the saliva of a great man contained his life power. Considering how difficult it is to communicate with a deaf-mute, Jesus’ goal seems to have been to prepare the man for healing by using an unusual sign of his intentions. Similarly, oil is a sign of God’s power to heal. Thus the anointing has a spiritual meaning.

If the meaning is spiritual, it is neither an anointing for office (as in the Old Testament) nor a sacrament (as the Roman Catholic tradition has claimed). James does not mention consecration for any office—whether prophet, priest, king, or church leader—in our passage. Nor is there anything like the custom of last rites, in which priests anoint the sick to remove remnants of sin from the dying soul. James stresses the efficacy of the prayer, not the oil, and he hopes for the healing of the living, rather than the salvation of the dying.

The anointing is not a sacrament, but it can symbolize the power of the Holy Spirit. By this anointing, the church’s leaders set apart the sick person for special attention, even healing, from God. This does not displace physicians, for all healing is spiritual. Wise physicians know they do not heal anyone. Christian physicians sometimes used to say, “I dress the wound, but God heals it.” Anointing is neither magical nor sacramental, but it is quasi-sacramental. Like other solemn ceremonies such as weddings or ordinations, the ceremony makes us pause so that we take the action seriously. The ceremony can arouse faith.

How to Proceed

If the basic concept of anointing and prayer for healing is clear, we still have to answer several practical questions in order to implement this teaching. For example, how sick does one have to be? James seems to have a major malady in view. The terms for the illness suggest something serious. The sick person is, literally, “weak” (asthenei) in James 5:14. In James 5:15 James uses the stronger term kamnō. It means “wear out” and suggests the weariness or exhaustion that often accompanies illness. It reminds us that sickness exhausts the spirit as well as the body. Pastorally speaking, this suggests that elders could lay hands on and pray for Christians who are afflicted spiritually. Depression, stress, and anxiety can wear us out more than some illnesses.

Notice that the sick person takes the initiative. He calls the elders, perhaps because he cannot travel. Further, the elders pray over him. This may signify that the sick man kneels. Or it may imply that a sick woman is bedridden. (Thus the scene is not a healing service; that is something James neither commends nor forbids.)

What We Seek

James 5:15–16 has both physical and spiritual healing in mind. We should seek more than a physical cure for more than physical problems. Physical healing is James’s main concern, but we must look past the body. The ESV expresses it well: “And the prayer of faith will save the one who is sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven. Therefore confess your sins to one another and pray for one another, that you may be healed.”

The first italicized term, rendered “save” (“make well” in the niv) is the Greek verb sōzō. It can mean “save” in the sense of saving the soul or in the sense of physical deliverance (e.g., Matt. 9:21–22; Mark 6:56; Luke 17:19). So then, in both English and Greek, one could say, “The Lord saved me when I was twenty years old.” But we could also say, “I think I will save this leftover food,” or “The lifeguard saved the life of a child today.” The word (in both English and Greek) can mean “save eternally,” from condemnation, or “save temporally,” from illness or loss.

In James 5:16, the word “healed” signifies physical healing. Therefore, we should pray for one another, for healing. Some Christians grow weary of praying about physical ailments. They want to pray for “more important things.” That is understandable, but it is still fitting to ask God to heal the body.

Other Christians claim that everyone can be healed, if he or she prays with enough faith. Conversely, if anyone is not healed, they can blame his or her lack of faith. This teaching doubles the misery for the chronically ill. They suffer their original problem, and they suffer the stigma of insufficient faith.

This kind of thinking, which mars some charismatic and Pentecostal churches, makes several mistakes. First, it forgets that God numbers our days, that everyone must die. Therefore, even the most faithful disciples suffer a final illness. No amount of faith will deliver them from it.

Second, Scripture notes that certain men of great faith were not healed of illnesses. Paul worked many miracles, but he did not heal associates such as Timothy (1 Tim. 5:23), Trophimus (2 Tim. 4:20), and Epaphroditus (Phil. 2:25). And the Lord never relieved Paul of his own “thorn in the flesh,” which was apparently a physical affliction (2 Cor. 12:7–10).

Third, James is not promising universal healing in this life. We already saw that the word “save” can mean a physical or a spiritual deliverance. The phrase “the Lord will raise him up” (James 5:15) also has two possible meanings. The Lord can raise the sick from their beds (Matt. 9:6; Acts 3:7). But in the New Testament, the Lord will “raise them up” often refers to the resurrection on the last day (John 6:40, 44, 54; 1 Cor. 15:15). The Lord raises up all the sick who believe in him—some in this life, some for eternal life. The Lord will heal all his people sooner or later. Some rise from sickness in this life, after prayer by the elders. But others rise bodily only on the last day, when the Lord raises the dead. Since he determines when he heals, we should not blame sick believers for their lack of faith.

The Role of Faith

Taken in isolation, the statement “the prayer of faith will save” (James 5:15 esv) seems to say that all who believe are healed, and only those who believe are healed. But Scripture’s testimony is more complex. If God healed people because he saw their faith, then God should have healed Paul and his associates of all their illnesses. They had faith and were not healed; therefore, we cannot ascribe lack of healing to lack of faith. Healing is a gift, not a reward. God does not owe healing to someone simply because she has strong faith.

Jesus teaches us to pray, “Your will be done” (Matt. 6:10; cf. James 4:15). The Lord grants or denies our requests as he wills. His sovereign purposes direct his actions. He has mercy as he wills (Rom. 9:18). It is a mistake to congratulate ourselves for strong faith when God grants a request and a mistake to blame ourselves when he refuses one.

Jesus performed miracles for several reasons. Miracles do seem to have rewarded faith when Jesus restored the sick, saying, “Your faith has healed/saved you” (Matt. 9:22; Mark 10:52; Luke 7:50). But compassion also moved him to heal people who did not clearly express faith (Matt. 20:34). When he raised the dead and delivered demoniacs, he healed people who couldn’t even ask for help. Some miracles stimulated faith by making people receptive to his message (John 2:23–3:2; 9:1–38). Other signs, performed for multitudes, revealed their lack of faith (John 6:1–41). Since Jesus bestowed wonders on unbelievers, such wonders could not simply have been rewards for strong or pure faith.

Yet, in the case James envisions, either the sick person or a close friend should expectantly call the elders. And the elders themselves should trust in God’s goodness and power. God will not heed a gathering of skeptics, who spin out a dead ritual.

James warns that the requests of doubters are ineffective (1:6). Yet the issue is not quality of faith, as if God hears prayers with “strong faith,” while prayers with “weak faith” fall short of heaven’s gates. Further, God will not violate his plan for us because we ask, with misguided faith, that he do so. He does, however, respond to our prayers of faith and alter things for our good. The Lord neither heeds wicked prayers (James 4:3) nor alters his good will because we ask him to do so. Yet the Lord does hear prayers that confess, “I believe; help my unbelief” (Mark 9:24 esv).

Sin and Sickness

The last clauses of James 5:15 read, “If he has sinned, he will be forgiven.” This reminds us that healing has a spiritual dimension. We should confess our sins because sin can lead to illness. This idea sounds antiquated, even offensive, but Scripture does draw a connection between sin and sickness.

In Jesus’ day, people overspiritualized illness. Many assumed that all tragedy and disease were direct consequences of sin. Today, in the West, we despiritualize illness. We believe microbes and defective genes cause all illness. We deny a link between sin and illness except in obvious cases such as cirrhosis of the liver and sexually transmitted diseases.

In fact, we need to respiritualize illness, for Scripture often links sin and illness.

  • Jesus said, “Your sins are forgiven,” then healed a paralytic (Luke 5:20).
  • He healed another crippled man by the pool of Siloam in Jerusalem and said, “Stop sinning or something worse may happen to you” (John 5:14).
  • Paul told the Corinthians that some of them had become sick and even died because they abused the Lord’s Supper (1 Cor. 11:30).
  • Acts says Herod Antipas died after an act of overweening pride (Acts 12).
  • Proverbs assumes that sin breeds illness (Prov. 3:28–35; 13:13–23).
  • Deuteronomy directly links sickness and distress to the sins of Israel as a nation (Deut. 28:58–63). But the covenant community enjoys God’s blessings when it is faithful. Ezekiel says the same principle applies to individual Israelites (Ezek. 18:1–29).

Nevertheless other passages deny that all illness is the result of personal sin. Whatever Job’s friends think (Job 8:1ff.; 22:1ff.), both Job and the Lord deny that he suffered because he sinned (Job 9:13–21; 29:1–30:31). Ecclesiastes also undercuts the sin-sickness nexus with meditations on the chaos and injustices of life (Eccl. 3:16–22; 5:12–17; 6:1–9). Once, the disciples asked Jesus about a man born blind: “Who sinned, this man or his parents, that he was born blind?” Jesus replied, “Neither” (John 9:2, 3).

James urges us to consider the possibility that the sick person has sinned. “If he has sinned,” James says, he can be forgiven. Sin may or may not be the root of an illness, but our time in bed gives us an opportunity for self-examination. When sickness idles us, we should use our solitude to scan our lives. If sins come to mind, we should confess them, repent, and endeavor to reform.

In Psalm 32:3-5, David says sin can wound the whole person, body and soul:

When I kept silent,

my bones wasted away

through my groaning all day long.

For day and night

your hand was heavy upon me;

my strength was sapped

as in the heat of summer.

Then I acknowledged my sin to you

and did not cover up my iniquity.

I said, “I will confess

my transgressions to the Lord”—

and you forgave

the guilt of my sin.

To some extent, then, spiritual health engenders physical health, and spiritual troubles beget physical sorrows. Again, James says, “Confess your sins to each other and pray for each other so that you may be healed” (James 5:16). Since sin causes some illnesses, and since physical healing through prayer remains James’s prime concern, he urges confession.

Confession of Sin (James 5:16)

It is easy to misunderstand the command to confess sins to one another. James cannot intend meetings where people confess any and every sin to each other. This is the only Bible verse that says, “Confess your sins to each other,” so the rest of Scripture must guide our thinking. Here are some salient biblical principles:

  1. The offender confesses to the one offended, whether to a human or to God.
  2. We confess secret sins to God, since sins such as anger, envy, or lust offend him, even if they never lead to action. It is highly unlikely that we will accomplish anything constructive by telling someone, “I envied you,” or “I lusted after you.”
  3. We confess private sins privately to the one or the few we offended. We confess public sins (which offend many) publicly. For example, if a leader propounds heresy, deceives his people, or misuses public funds, public confession is apt.

The confession James recommends must fit category three. Once a sick and sinning believer repents, fellowship is restored (James assumes that the offended party will be ready to forgive). Then the whole body of Christ can pray effectively for healing.

James expects those prayers to be effective, for “the prayer of a righteous man is powerful and effective” (James 5:16). Elders are responsible to set an example of personal righteousness, yet James 5:16 expects the whole church to pray. Every saint—everyone who is righteous by faith—prays.

Still, the efficacy of a prayer lies in the grace and power of God, not the goodness and merit of the petitioner. The prayers of the righteous have power, yet God gives us that righteousness by faith and by the Holy Spirit.

Effective Prayer Illustrated (James 5:17–18)

Elijah illustrates how effective the prayer of the righteous can be. During the reign of wicked king Ahab, Elijah prayed, at God’s direction, “that it would not rain, and it did not rain on the land for three and a half years. Again he prayed, and the heavens gave rain, and the earth produced its crops” (James 5:17–18).

Elijah illustrates effective prayer in important ways. First, Elijah was a righteous and faithful man, yet he certainly was not a perfect man. At times, he so indulged his fears that he ran away, despaired of life, and petitioned God to take him (1 Kings 19:1–11). Still, God heard his prayers, whether for drought or for rain.

Second, notice that James does not call Elijah a prophet, does not emphasize his special relationship with God. He calls Elijah a man “just like us” (niv). He had the same “nature” (esv) or “passions” (kjv) as the rest of us. Like us, he served from a position of weakness. He felt the world’s powers arrayed against him. He was prone to despair. He was not worthy, he was simply a righteous man who prayed, for individuals and for his society.

We can pray just like Elijah. We may feel weak and lonely. We may feel powers against us. In prayer, we may admit that we fear those powers, yet our prayers also declare that the greatest powers are unseen. The power of God heals disease and changes the world.

Seeking Physical Healing

The Lord wants his children to seek him both when we prosper and when we falter. If sick, we should pray for healing. If seriously ill, we should seek the elders to pray on our behalf. But we are reticent to obey, for several reasons. First, prayer for healing seems unscientific and naïve. If we get infections, we take antibiotics. If we have cancer, we seek chemotherapy. We think, “Microbes and damaged genes cause illness, not sin.”

Second, pride stops us. We feel embarrassed when we have to ask for help. But we ought to face our needs. If we can ask God for aid, we can surely ask men and women.

Third, we fear disappointment. What if we ask—ask fervently—and nothing happens? We can’t bear the thought. Functional deism also blocks our prayers. We confess, in some abstract way, that God is powerful and effective. We expect him to change hearts, but we cannot imagine that he intervenes to heal bodies today. So our prayers wither away.

Even apart from physical healing, it is every pastor’s privilege to pray with frightened, immature Christians and to pray with heroes of the faith and watch the Lord calm and comfort them. Every Christian leader has blessed stories to tell of God’s extraordinary provision, whether of healing from illness or peace despite illness. But this we know: whether we call such things “miracles” or “healings” or “signs,” God still acts, in history, in supernatural ways.

It is fitting that James starts to conclude his book with this invitation to pray over every joy and sorrow. Expectant prayers manifest the faith that is so central to James. When we make our needs known and confess our sins, we endure our trials and live in gospel humility.

Seeking Spiritual Healing (James 5:19–20)

The last verses of James seem to initiate a new topic. But on closer inspection, they develop previous themes. First, if the family of God prays together when physical illness wounds a member, they should certainly work together if spiritual troubles threaten. James says: “My brothers, if one of you should wander from the truth and someone should bring him back, remember this: Whoever turns a sinner from the error of his way will save him from death and cover over a multitude of sins” (James 5:19–20). Technically, James makes a promise: if someone restores someone who wanders from the truth, he “will save him from death and cover over a multitude of sins” (James 5:19). More broadly, James tells us what to do if someone strays from the truth. That “someone” may or may not be a member of the visible Christian community. The phrasing—“My brothers, if one of you should wander”—inclines us to think of fellow believers, but James also had unbelievers in sight. Some had a vain faith (James 2:14–26); some had no faith at all (James 5:1–6). James says that when we see anyone stray, we should try to restore him.

Earlier, James reported another approach. Some prefer to slander and judge those who (in their opinion) stray (James 4:11–12). Both here and in James 4:11–12, someone detects an error in another. The difference lies in the goal of the analyst. Slanderers and gossips speak ill in order to judge. They usurp God’s prerogatives and condemn sinners, instead of lending aid. But we should diagnose sin in order to bring restoration and a covering for sin.

At the simplest level, James says anyone might need assistance to stay in the way of righteousness. The church retains its integrity, its essence, when we render mutual assistance, including moral and spiritual correction, if necessary.

The concept of wandering “from the truth” implies that James assumes there is objective truth “out there,” apart from the knower. Richard Rorty says reality is a social construction, and “the truth” is simply language suited to our current purposes. He says ethics really only asks questions such as: “Is this prudent? Is it efficient? Is it an expedient adjustment to changing circumstances?” But the Christian says there is a way of truth that leads to life and there is a way of error that leads to death. Without restoration, the sinner is alienated from the church and lost to God.

The brother who reclaims a sinner “will save his soul from death” (James 5:20 esv). It is possible, grammatically, to interpret this to mean the reclaimer will save his own soul. Some interpreters think James means to encourage intervention by suggesting that one can find or obtain forgiveness of his own sins by interceding for others. To be sure, God’s servants assure themselves of their status before him when they discharge their duties. For example, the Lord told Ezekiel that if he failed to warn the wicked, “his blood I will require at your hand” (Ezek. 3:18 esv). But if he warned the wicked to turn from sin and urged the righteous to stay true, then whether they heeded him or not, God said, “you will have delivered your soul” (3:19, 21 esv). The Lord blesses faithfulness. When we fulfill our God-given duties, we gain assurance of our salvation (1 Tim. 4:16). Further, God often treats us as we treat others. If we pursue God’s grace for the forgiveness of others, he will forgive us (Matt. 6:14–15). But we do not earn salvation by working to restore a sinner.

The restorer’s goal is not selfish, therefore. He seeks to “cover a multitude of sins” not by overlooking sins committed against him. Proverbs does bless those who overlook personal offenses (Prov. 10:12; 19:11), but personal offenses are not in this context. The “covering” must then be God’s covering of sin. Therefore, Christians should gather their courage and speak—plainly and truthfully—to sinners, calling them to turn from sin and to the mercy of Christ.

These final thoughts of James unite several themes of his epistle. To pursue a sinner in order to win him to Christ is a proper response to a trial (James 1:2–12). It is a form of kindness to a brother (James 2:14–26), a proper use of speech (James 3:1–12), and it leads people to humble themselves before the Lord (James 4:6–10). James summons us to do the word and reap the blessings (James 1:22–25). One more time, James reminds us that sin leads to death, and that the gospel, the word of truth, saves the soul (James 1:15, 21).