This article appeared in byFaith, the magazine of the Presbyterian Church in America.

It sounds so simple. Pastors could so easily pray for the sick—pointedly and intelligently—couldn’t they? But so often these prayers from the pulpit sound like a nursing report at shift change in your local hospital: "The colon cancer in room 103 with uncertain prognosis … the lady in 110 with a gall bladder that’s not yielding to treatment … the broken leg that’s mending well … the heart patient going into surgery on Tuesday under Dr. Jones’s skilled hands … .”

Visitors to many of our churches might understandably conclude that God isn’t very good at doing what we ask, that He is just there to perk up our health. Chronic illnesses gradually fill up our prayer lists, and deep down we know that every person in every pew will die sooner or later. Pastoral prayers, prayer meetings, and prayer lists can have the net effect of actually disheartening and distracting the faith of God’s people. Prayer becomes either a dreary litany of familiar words, or a magical superstition verging on hysteria. This kind of prayer either dulls our expectations of God, or hypes up fantasy presumptions.

Prayers for the sick can even become a breeding ground for cynicism: those who improve would have gotten better anyway, right? This is easy to believe as nature takes its course or as medical interventions bring about predictable results. Or those who don’t improve may be questioned about their faith. Prayer can become a breeding ground for bizarre ideas and practices—a spiritually sanctioned version of the exact same obsession with health and medicine that characterizes the wider culture, naming and claiming your healing, a superstitious belief that the quantity or the fervency of prayer is decisive in getting God’s ear; the notion that prayer has some intrinsic “power.”

Changing How We Pray

It’s hard to learn how to pray—for the sick as well as the healthy. How often do we make intelligent, honest requests for something we need from capable, trustworthy friends? Prayer is a lot like that. But somehow when the making of a request is termed “praying” and the capable party is termed “God,” things tend to get tangled. You’ve seen it, heard it, done it: the contorted syntax, formulaic phrasing, meaningless repetition, “just reallys,” vague non-requests, artificially pious tone of voice, air of confusion. If you talked to your friends or parents that way they’d think you’d lost your mind. But what if your understanding of prayer changes, and if your practice of prayer then changes? What then? What if the prayer requests you make—and the ones you ask others to make—change?

Consider a few factors that can bring about such change.

The Sick: Keeping Spiritual Issues in View

First, notice a few things about James 5:13-20. This passage is the warrant for praying for the sick. It is certainly significant that James explicitly envisions prayer not in a congregational setting, but in what we might think of as a counseling setting. The sick person asks for help, meets with a few elders, honestly confesses sins, repents, and draws near to God. James describes earnest prayer as affecting both the physical and spiritual state of that person. Is it wrong to pray from the pulpit for sick people? Of course not. But we should consider that the classic text on praying for the sick describes something highly personal and interpersonal.

Notice also how pointedly James keeps spiritual issues in view. His letter is about growing in wisdom, and he doesn’t change that emphasis when it comes to helping the sick. What he writes is predicated on his understanding that suffering presents an occasion to become wise, a good gift from above: “Count it all joy when you meet various trials … If anyone lacks wisdom, let him ask … .” He has already illustrated this regarding the issues of poverty, injustice, and interpersonal conflict. Now he illustrates it regarding sickness.