Pastor and Christian Leadership Resources

Praying Beyond the Sick List

  • David Powlison Journal of Biblical Counseling
  • 2006 22 May
Praying Beyond the Sick List

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.

James’ focus on spiritual issues does not mean that people get sick because they’ve sinned. They do sometimes: IV drug use and sexual immorality do, for instance, lead to AIDS on occasion. People do reap in sickness what they sow in sin. But made into a universal rule, that idea is mere superstition. Remember Job’s heartless counselors.

God meets us in sickness, and we experience new dynamics through that meeting. Sickness can force us to stop and face ourselves, to stop and find the Lord. We discover sins we’ve been too busy to notice: neglectfulness, irritability, indifference, self-indulgence, unbelief, joylessness, worries, complaining, drivenness in work, trust in our own health and ability. As our need for Jesus’ mercies is quickened, our delight in God deepens. We will develop fruit of the Spirit that can develop no other way than by suffering well: endurance of faith, hope and joy that transcend circumstances, mature character, richer knowledge of the love of God, living for God not self, the humility of weakness, the ability to help others who suffer. (See Jam. 1:3; Rom. 5:3-5; 1 Pet. 1:6-8, 4:1-3; 2 Cor. 12:9f.)

And sickness, like any weakness or trouble, is itself a temptation. Whether you face life-threatening disease or just feel lousy for a couple days, it is amazing what that experience can bring out of your heart. Some people complain and grumble, getting grouchiest with the people who care most. Others get angry—at God, at themselves, at others, at the inconvenience. Others pretend nothing is wrong, denying reality. Others pretend they’re sicker than they are, seeking an excuse to avoid the responsibilities of job, school, or family. Some invest vast hopes, time, and money in pursuing doctor after doctor, book after book, drug after drug, diet after diet, quack after quack. Still others keep pressing on with life, doing, doing, doing—when God really intends that they stop and learn the lessons of weakness. Others become deeply fearful—“perhaps this is the big one”—imagining the worst, And others get depressed. Feeling lousy physically becomes an occasion to question the meaning and value of their entire existence. Some are too proud or embarrassed to ask for help. Others manipulate everyone within reach to serve their every need. Some brood that God must be out to get them, becoming morbidly introspective about every real or imaginary failing.

Sickness provides one of the richest opportunities imaginable for spiritual growth and pastoral counseling, as James 5 makes clear. Is God interested in healing any particular illness? Sometimes, sometimes not. But is He always interested in making us wise, holy, trusting, and loving, even in the context of our pain, disability, and dying? Yes, yes again, and amen.

People learn to pray beyond the “sick list” when they realize what God is really all about.

Longing for Christ’s Kingdom

Consider the vast biblical teaching on prayer. How many of Scripture’s prayers focus on sickness? A significant few, giving good warrant to plead passionately with God for healing. In Isaiah 38, Hezekiah pleads for restoration of health, and he is healed. In 2 Corinthians 12, Paul prays earnestly three times to be delivered from a painful affliction—but this time God says no. Psalm 35:12-14 mentions heartfelt prayer for the restoration of the sick, and portrays this as a natural expression of loving concern. Both Elijah and Elisha passionately plead with God on behalf of only sons whose sicknesses end in death, devastating their mothers (1 Kings 17; 2 Kings 4). In both cases God mercifully restores them. Coming at the issue from the opposite direction, the Bible’s last word on Asa is negative because “his disease was severe, yet even in his disease he did not seek the LORD, but the physicians” (2 Chronicles 16:12). He is chided for failing to pray through sickness. Prayer has varying degrees of intensity, with supplication and outcry being the strongest. It is striking how passionate and blunt the prayers for healing are. These passages vividly challenge the perfunctory and medicine-centric prayers that often are said, even by people preoccupied with praying for the sick. When you pray for the sick, and as you teach the sick to seek God for themselves, it ought to be a fiercely thoughtful firestorm.

However, the majority of prayers in the Bible focus on other things. As shorthand, here are three emphases of biblical prayer: circumstantial prayers, wisdom prayers, and kingdom prayers. Praying for the sick is one form of the first.

1. Sometimes we ask God to change our circumstances—heal the sick, give us daily bread, protect us from suffering and evildoers, make our political leaders just, convert our friends and family, make our work and ministries prosper, provide us with a spouse, quiet this dangerous storm, send us rain, give us a child.
2. Sometimes we ask God to change us—deepen our faith, teach us to love each other, forgive our sins, make us wise where we tend to be foolish, help us know You better, give us understanding of Scripture, teach us how to encourage others.
3. Sometimes we ask God to change everything by revealing Himself more fully on the stage of real life, magnifying the degree to which His glory and rule are obvious—Your kingdom come, Your will be done on earth as it is in heaven, be exalted above the heavens, let Your glory be over all of the earth, let Your glory fill the earth as the waters cover the sea, come Lord Jesus.

In the Lord’s prayer we see examples of all three. They are tightly interwoven when we pray rightly. The Lord’s kingdom (#3) involves the destruction of our sins (#2) and our sufferings (#1). His reign causes a flourishing of love’s perfect wisdom and a wealth of situational blessing. Prayers for God to change my circumstances and to change me are, in their inner logic, requests that He reveal His glory and mercy on the stage of this world.

When any of these three strands of prayer gets detached from the other two, prayer tends to go sour. If you just pray for better circumstances, then God becomes the errand boy (usually somewhat disappointing) who exists to give you your shopping list of desires and pleasures—no sanctifying purposes, no higher glory. Prayer becomes gimme, gimme, gimme. If you only pray for personal change, then it tends to reveal an obsession with moral self improvement, a self-absorbed spirituality detached from engaging with other people and the tasks of life. Where is the longing for Christ’s kingdom to right all wrongs, not just to alleviate my sins so I don’t feel bad about myself? Prayer pursues self-centered, morally-strenuous asceticism, with little evidence of real love, trust, or joy. If we only pray for the sweeping invasion of the kingdom, then prayers tend towards irrelevance and overgeneralization, failing to work out how the actual kingdom rights real wrongs, wipes away real tears, and removes real sins. Such prayers pursue a God who never touches ground until the last day.

Practicing the Three Strands of Prayer

We could give countless examples of these three strands of prayer operating wisely. Let me note a few. Consider the Psalms, the book of talking with God. About 90 psalms are “minor key.” Intercessions regarding sin and suffering predominate—always in light of God revealing His mercies, power, and kingdom. The battle with personal sin and guilt appears in about one third of these intercessions. Often there are requests that God make us wiser: “teach me,” “make me understand,” “revive me.” God reveals Himself (“for your name’s sake”) by changing us. Many more psalms reveal requests to change circumstances: deliver us from evildoers, be our refuge and fortress amid suffering, destroy Your enemies. These, too, are always tied to requests that God arrive with kingdom glory and power. God reveals Himself by making all these bad things and bad people go away. Then there are the 60 or so “major key” psalms. In these you see emphasis on the joy and praise that characterize God’s kingdom reign in action.

Look at the prayers of Philippians 1:9-11 and Colossians 1:9-14. There is no mention of circumstances, no requests to be healed, fed, protected, or for other people to change. The requests focus entirely on gaining wisdom in the light of the coming glory of God’s kingdom. These two prayers plead with God on behalf of other people that two kinds of love would deepen: May God make you know Him better. May God make your love for people more intelligent.

Look too at Ephesians 1:15-23 and 3:14-21. These intercessions focus on wisdom in the light of Christ’s glory. Again, there are no circumstantial requests. In fact, there aren’t even requests to grow in intelligent love for others. But Paul zeroes in on what we most need: I ask that God would make you know Him better.

Praying Beyond the Sick List

Why don’t people pray beyond the sick list? We want circumstances to improve so that we might feel better and life might get better. These are often honest and good prayers—unless they’re the only requests. Unhinged from the purposes of sanctification and from groaning for the coming of the King, prayers for circumstances become self-centered. Learn, and teach others, to pray with the three-stranded braid of our real need. You will pray far beyond the sick list. And you will pray in a noticeably different way for the sick.

David Powlison is editor of the Journal of Biblical Counseling and is a counselor and faculty member of the Christian Counseling and Educational Foundation. Dr. Powlison is the author of Speaking Truth in Love (Punch Press, Winston-Salem, NC, 2005.)

This article appeared in byFaith, the magazine of the Presbyterian Church in America. © 2006 Christian Counseling and Educational Foundation. Used by permission. All rights reserved. This article is adapted from one published in the Journal of Biblical Counseling Vol. 23 No. 1. For information on how to become a Journal subscriber visit our website at or contact CCEF Customer Service at 1.800.318.2186.