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Guide XIII-159

Healing prayer (Mi Sheberach)

A 41 · L 46 · M 1314 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the traditional synagogue Mi Sheberach for the sick as described in Tracey R. Rich's Judaism 101 "Prayers for Healing" page; the Conservative movement's guidance in the Rabbinical Assembly study guide Mi Shebeirakh: Refuat Hanefesh u'Refuat Haguf (built on the teshuvah by Rabbis Greyber and Peltz); and the Reform sung setting by Debbie Friedman as republished by reformjudaism.org from Mishkan HaNefesh for Youth (CCAR, 2018). Orthodox and Sephardi wordings differ in detail and are not followed here [uncertain: not verified].

Mi Sheberach ("May the One who blessed…") is a Jewish prayer in which one person or a congregation asks God, invoked as the One who blessed the ancestors, to send healing to a named person who is ill or injured. In tradition it asks for refuat hanefesh u'refuat haguf, healing of the soul and healing of the body [source: Rich; RA study guide]. It is usually said in synagogue during the Torah reading, between the sections read (aliyot), but may be said at any time of need [source: Rich]. A separate communal blessing for healing, beginning "Refa'enu" ("Heal us"), is part of the weekday Amidah and is not said on Shabbat or festivals [source: Rich; Barth/JTS]. William Cutter traces Mi Sheberach from a blessing for the whole community to an occasional prayer for particular needs, with many regional versions tied to the Torah or Haftarah reading; he reports that Friedman's sung setting spread it through liberal congregations by about 1995 [source: Cutter, Sh'ma 2011]. Her version is now part of the Reform prayer book [source: Forward].

How change happens, as the tradition and its teachers frame it: the prayer places the sick person's need before God and before the community. The Rabbinical Assembly guidance frames prayer for others as valuable in itself and as a way of cultivating a caring community, not as a means of controlling outcomes, and holds that healing is "not only physical, but also emotional and spiritual" [source: RA study guide]. Cutter, drawing on Friedman, distinguishes curing, which doctors do, from healing, which everyone must do [source: Cutter]. Rabbi Samuel Barth (JTS) honours the work of physicians while arguing the soul is always involved in healing [source: Barth/JTS]. These are religious claims, attributed to their authors, not clinical ones.

Health claims and evidence status (one line): a Cochrane review of intercessory prayer (Roberts, Ahmed and Davison 2009; 10 trials, 7,646 patients) found the evidence equivocal and "does not support a recommendation either in favour or against" [source: Cochrane]. Mi Sheberach is not a treatment for physical disease; it is used alongside medical care, which continues in full. For the psychotherapist, the prayer is a resource of meaning, hope, belonging and grief that the client may bring into therapy, within spiritually integrated psychotherapy (see Domain VII), and 223 covers intercessory prayer for healing across traditions.

2. Framework

This is a prayer practice, not a therapy protocol, so it has no phases, session count or session format in its sources [source: Rich; RA study guide]. The tradition's own structure is liturgical:

  • Communal recitation: during the Torah service (Shabbat, and weekday readings), often between aliyot; congregants may stand and say the names of people they are worried about, or names are read from a list kept by the congregation [source: Rich; Cutter]. In Reform and many liberal congregations it is sung, commonly to Friedman's melody [source: Barth/JTS; reformjudaism.org].
  • Private recitation: any time of need, by one person on behalf of another [source: Rich]; the RA guidance also encourages individual prayer for anyone one believes needs healing [source: RA study guide].
  • Daily communal blessing: Refa'enu within the weekday Amidah, a prayer for all who are ill in the community rather than for one named person [source: Rich].
  • The list over time: names are added with consent, and removed when the person dies or asks to be removed; some communities reset the list on a fixed calendar (for example monthly on Rosh Hodesh, or at Passover and Rosh Hashanah) unless names are re-added [source: RA study guide].

For the therapist, a workable sequence is [synthesis]: (1) notice or invite the topic during spiritual assessment; (2) understand what the prayer means to this client and their community; (3) agree, at the client's lead, whether and how it enters therapy (as a topic, a between-session practice the client already does, or a link to their rabbi or chaplain); (4) work with what it evokes (hope, fear, guilt, unanswered prayer, grief, scrupulosity); (5) review. Move on from assessment only when the client has said clearly that they want this in the work; return to assessment whenever distress about the prayer rises. No source gives session counts or durations for this work.

3. Guiding principles

  • Client-led and in the client's own tradition. The client decides whether prayer enters therapy, in which words and which movement's version; you follow their usage, not your own [source: Vieten et al. 2013 abstract; synthesis].
  • Consent governs naming. The RA guidance holds that "A person should only be the object of communal prayers with their consent"; in practice, ask before anyone is named, and respect a client's wish not to be named [source: RA study guide].
  • Medical care continues. Practically, every conversation about healing prayer leaves the client's medical treatment in place and routes health questions to their doctor; physicians' work is honoured in the tradition's own teaching [source: Barth/JTS; Cutter; Cochrane].
  • Healing is wider than cure. As Cutter and the RA guidance frame it, healing can include emotional, spiritual and communal healing even when cure is not possible; use this to open meaning, not to promise outcomes [source: Cutter; RA study guide].
  • Concepts are attributed, neither asserted nor dismissed. Speak of what "your tradition teaches" or "what you believe" about God's role, without endorsing or debunking [synthesis].
  • Community is part of the practice. The prayer is usually communal; ask about the client's congregation, rabbi and support network as resources [source: Cutter; RA study guide].
  • Watch for struggle as well as comfort. Religious struggle (feeling punished or abandoned by God) during serious illness is a clinical warning sign that merits attention and possible chaplain referral [source: Pargament et al. 2001 as reported by ReliasMedia].
  • The therapist is not clergy. You do not lead the prayer, rule on Jewish law, or act as the client's rabbi; you refer and collaborate when the client wishes [source: RA study guide on clergy role; synthesis].
  • Scrupulosity can attach to prayer. Precision about words, names or concentration (kavanah) can become obsessional; treat it as OCD with rabbinic consultation, not as piety to reinforce [source: IOCDF, Siev].
  • No targets. There are no counts, durations or schedules to prescribe; the client's own observance sets the pattern [synthesis].

4. Intervention inventory

The first item describes the prayer as the tradition publicly teaches it, so the therapist knows what the client is doing; the therapist does not teach or lead it. The remaining items are the psychotherapist's own work alongside it.

4.1 The prayer as publicly taught (for the therapist's understanding)

  • Purpose and when to use: to understand what a client means when they say they "put a name in", "said a Mi Sheberach" or were "on the list" [source: Rich; RA study guide; Cutter].
  • Steps (as the sources describe them, in paraphrase):
    1. A person who wants healing for someone, or the person themselves, gives the name to the congregation (often to the rabbi or office) or says it during the Torah service; in many congregations people stand and say names aloud at the set point [source: Cutter; RA study guide].
    2. The name used is the person's given name and their mother's name, preferably Hebrew names; one should not invent a Hebrew name, but use the name the person actually uses. Rich explains the use of the mother's name by tradition about spiritual lineage and by the image of a weeping mother seeking mercy [source: Rich]. In the RA guidance, consent covers whether the name is said in Hebrew or English [source: RA study guide].
    3. The leader recites or the congregation sings the prayer: it invokes the One who blessed the ancestors (in liberal versions, patriarchs and matriarchs), asks blessing and healing for the named people, and asks for healing of soul and body; it ends with "Amen" [source: Rich; reformjudaism.org].
    4. Traditional versions differ for a man and a woman (the male version refers to the traditional count of bodily parts and sinews) and include a pledge of charity (tzedakah); Rich advises skipping the pledge if one does not intend to give, and notes the gift can be small [source: Rich].
    5. Names stay on the list while the person consents; they come off at death or on request, or at a periodic reset [source: RA study guide].
  • Example language (illustrative): "When your name was read on Shabbat, what was that like for you?"
  • Watch for: the client's movement (Reform, Conservative, Orthodox, Sephardi, unaffiliated) changes the words and customs; ask rather than assume [synthesis].

4.2 Spiritual history and meaning-assessment

  • Purpose and when to use: at intake and when illness (the client's or a loved one's) enters therapy; Pargament and colleagues recommend a routine spiritual history including affiliation and how important faith is [source: Pargament et al. 2001 via ReliasMedia]. Vieten et al. (2013) propose basic spiritual and religious competencies, including attitudes, knowledge and skills, for all licensed psychologists [source: Vieten et al. 2013 abstract].
  • Steps:
    1. Ask open questions about tradition, community, and what prayer means in the client's life.
    2. Ask specifically what the healing prayer means to them: comfort, duty, hope of cure, connection, fear.
    3. Ask who prays for them and for whom they pray; map the congregation, rabbi and family as resources.
    4. Use the DSM-5-TR Cultural Formulation Interview, including its supplementary module on spirituality, religion and moral traditions, where your service uses it [uncertain: not verified].
    5. Record the client's own words and spelling of terms [synthesis].
  • Example language (illustrative): "Some people find it a comfort to be prayed for, and some find it complicated. What has it been like for you?"
  • Watch for: relief at being asked; or guarded replies that suggest earlier experiences of religion being dismissed. It is working when the client brings the topic up again without prompting [synthesis].

4.3 Client-led integration into therapy

  • Purpose and when to use: when the client asks for their prayer life, including Mi Sheberach, to be part of the work; spiritually integrated psychotherapy (Domain VII) [source: Vieten et al. 2013 abstract; synthesis].
  • Steps:
    1. Get explicit consent for bringing prayer into therapy and agree its scope.
    2. Let the client choose how: discussing it, saying it themselves at home or in synagogue, reflecting on it in session. If a client wishes to say a prayer in session, they say it; the therapist does not lead [synthesis].
    3. Link it to therapy goals the client sets (for example, coping with a parent's illness, feeling less alone).
    4. Review whether it helps or adds pressure.
  • Example language (illustrative): "You said singing it on Shabbat steadies you. Would it help to talk about what you are asking for when you sing it?"
  • Watch for: the client deferring to you as a religious authority; prayer used to avoid painful feelings rather than hold them. Working: more hope, connection or capacity to act, with medical care unchanged [synthesis].

4.4 Consent, naming and privacy

  • Purpose and when to use: when the client wants to be named, wants to name someone else, or is upset at being named without asking.
  • Steps:
    1. Explore the client's wishes: Hebrew or English name, public or private [source: RA study guide].
    2. Note the RA position that people should be prayed for communally only with consent, and that a loved one may consent when the person cannot; otherwise privacy is respected and the name not read aloud [source: RA study guide].
    3. Where a diagnosis is stigmatised (mental illness, for example), discuss what being named will disclose; the RA guidance explicitly includes people with mental or chronic illness and lists prayers for these conditions [source: RA study guide].
    4. Support the client in telling their rabbi or office what they want, or in asking to be removed [source: RA study guide; synthesis].
  • Example language (illustrative): "You'd like support from the community but not for everyone to know it's depression. What would feel right to tell them?"
  • Watch for: shame, fear of gossip, family pressure about who is named. Working: the client feels in charge of their own disclosure [synthesis].

4.5 Healing versus curing: meaning-making alongside medical care

  • Purpose and when to use: when the client equates the prayer with cure, or feels the prayer "failed".
  • Steps:
    1. Ask what the client hopes the prayer will do.
    2. If they wish, explore their tradition's own distinction between curing and healing, citing the teachers who make it (Friedman as reported by Cutter; the RA guidance) rather than presenting it as your view [source: Cutter; RA study guide].
    3. Affirm that medical treatment continues and that their doctor is the person for health decisions; the tradition's own teachers honour physicians [source: Barth/JTS].
    4. Identify kinds of healing still possible: relationships, peace, belonging, forgiveness [synthesis].
  • Example language (illustrative): "Your rabbi talks about healing that isn't only about the body. Does that fit for you, or does it feel like a consolation prize?"
  • Watch for: a reframe that feels dismissive of the wish for cure; any sign the client or family is postponing treatment in favour of prayer, which goes straight to the doctor and, where relevant, safeguarding [synthesis].

4.6 Working with religious struggle and unanswered prayer

  • Purpose and when to use: when the client feels punished, abandoned or unloved by God, angry at God, or attributes illness to evil forces. In a study of 595 older medical inpatients, Pargament and colleagues found religious struggle associated with higher two-year mortality after adjustment; the authors offered mechanisms only as hypotheses, and stressed that most patients do not report struggle [source: Pargament et al. 2001 via ReliasMedia].
  • Steps:
    1. Do not raise struggle unprompted, but do not avoid it when the client brings it [source: Pargament et al. 2001 via ReliasMedia].
    2. Listen to and acknowledge anger or guilt; talking about it can itself help [source: Pargament et al. 2001 via ReliasMedia].
    3. Screen for depression and suicidal thinking using your service's standard risk assessment [source: Pargament et al. 2001 via ReliasMedia; synthesis].
    4. Offer a chaplain or rabbi referral for the theological questions [source: Pargament et al. 2001 via ReliasMedia].
    5. Explore whether the tradition itself holds room for lament and protest (the client or their rabbi may name sources) [synthesis].
  • Example language (illustrative): "It sounds as if, when the prayer didn't change the scan, part of you heard that God had turned away. Can we stay with that for a moment?"
  • Watch for: chronic, unresolved struggle, which the authors linked to more risk than a brief crisis [source: Pargament et al. 2001 via ReliasMedia]. Working: struggle becomes speakable, and the client reconnects with community or clergy.

4.7 Caregivers and people praying for others

  • Purpose and when to use: when the client is the one naming a sick parent, child, partner or friend. The RA guidance frames prayer for others as cultivating concern for others [source: RA study guide].
  • Steps:
    1. Explore what saying the name each week holds for them: hope, helplessness, love, dread.
    2. Identify the practical care they also give (visiting, bikur holim); the RA guidance pairs prayer with visiting and caring community [source: RA study guide].
    3. Attend to caregiver strain and anticipatory grief [synthesis].
    4. Where the charity pledge matters to them, explore it as an act of agency, without advising amounts [source: Rich; synthesis].
  • Example language (illustrative): "Each Shabbat you stand and say her name. What happens in you in that moment?"
  • Watch for: guilt that their prayer was not "good enough"; magical responsibility for the outcome (consider 4.10). Working: the ritual carries love and is not a test they can fail [synthesis].

4.8 Terminal illness, death and grief

  • Purpose and when to use: when the person prayed for is dying or has died.
  • Steps:
    1. Note the RA guidance: for terminal illness one may say a Mi Sheberach, but it may be wiser to pray for the patient's and family's needs; such prayer is not in vain because spiritual healing is still needed [source: RA study guide].
    2. Help the client choose what they now want to pray for, if anything [synthesis].
    3. When the name comes off the list at death [source: RA study guide], explore the loss this marks; link to mourning rites and community through the client's rabbi [synthesis].
  • Example language (illustrative): "Your rabbi suggested praying for peace now, rather than cure. How does that sit with you?"
  • Watch for: the end of the prayer felt as a second loss or as abandonment by the community; complicated grief. Working: the client finds a form of prayer or ritual that fits where they are [synthesis].

4.9 Referral and collaboration with rabbi or chaplain

  • Purpose and when to use: questions of Jewish law or theology, wishes to pray with a clergy member, spiritual struggle, or scrupulosity needing a posek. The RA guidance encourages notifying a sick person's rabbi and advises clergy to reach out when in doubt [source: RA study guide]; Pargament and colleagues recommend chaplain referral [source: Pargament et al. 2001 via ReliasMedia].
  • Steps:
    1. Ask the client whether they want a rabbi, cantor or chaplain involved, and whom.
    2. Obtain written consent and agree what is shared [synthesis].
    3. Define roles: clergy for prayer, ritual and law; therapist for psychological care [synthesis].
    4. Follow up together if the client wishes.
  • Example language (illustrative): "That's a question for someone who can speak for your tradition. Would you like to ask your rabbi, or would a hospital chaplain be easier?"
  • Watch for: the client wanting you to replace their clergy; clergy advice that conflicts with medical care (route to the doctor). Working: the client has both supports, clearly distinct [synthesis].

4.10 Scrupulosity around the prayer

  • Purpose and when to use: when the client repeats names or the prayer to get it "right", fears an error in the Hebrew name or mother's name will harm the sick person, doubts their concentration (kavanah), or repeatedly asks rabbis the same question. Siev (IOCDF) describes Jewish scrupulosity including concerns about articulation, enunciation and kavanah in prayer and over-asking rabbinic questions (shaylas) [source: IOCDF, Siev].
  • Steps (ERP adapted, with consent):
    1. Assess for OCD; distinguish devotion from compulsion by function (anxiety-driven, never satisfied) [source: IOCDF, Siev; synthesis].
    2. With the client's consent, consult their rabbi or posek to separate actual religious requirements from OCD rules [source: IOCDF, Siev].
    3. Build exposures that "violate the rules of OCD" without violating religious law, for example saying the prayer once at the usual pace without repeating, within what the rabbi confirms is permissible [source: IOCDF, Siev; example is synthesis].
    4. Use the halakhic principles Siev lists (for example that one need not hedge against highly unlikely possibilities, and that perfection is not a religious legal standard) as the rabbi applies them, not as your own rulings [source: IOCDF, Siev].
    5. Obtain informed consent for exposure; agree pacing and the right to stop; ERP is contraindicated where the client cannot consent or is in acute crisis [synthesis].
  • Example language (illustrative): "Your rabbi said once is enough. The OCD says once is never enough. Shall we practise letting the rabbi's answer stand?"
  • Watch for: reassurance-seeking moving to you; the client fearing that resisting compulsions harms the sick person. Working: shorter, calmer prayer, fewer repetitions, prayer felt as devotion again [source: IOCDF, Siev; synthesis].

4.11 Trauma-sensitive adaptation and adverse experiences

  • Purpose and when to use: when prayer or synagogue settings evoke trauma (medical trauma, religious trauma, loss), or when prayer becomes absorbing and distressing. Mi Sheberach is a short spoken or sung petition, not an intensive meditation, so research on meditation adverse effects applies only by analogy [synthesis]. That research shows challenging experiences are real: the Varieties of Contemplative Experience study (Lindahl et al. 2017, PLOS ONE) documented meditation-related challenges from over 100 interviews [source: Cheetah House VCE], and a 2020 systematic review in Acta Psychiatrica Scandinavica (Farias et al.; 83 studies, 6,703 participants) found a pooled adverse-event prevalence of 8.3%, most often anxiety, depression and cognitive anomalies, including in people without prior mental health history [source: PubMed 32820538].
  • Steps:
    1. Ask whether hearing names read, standing in the congregation or hospital prayer brings up distress [synthesis].
    2. Offer choice and control: the client may pray privately, have a loved one name them, or decline being named [source: RA study guide; synthesis].
    3. Use grounding (orienting to the room, feet on the floor, eyes open) if a prayer memory triggers flashbacks in session; trauma-sensitive mindfulness (Treleaven 2018) is a published adaptation for meditation contexts [uncertain: not verified].
    4. Reduce exposure: shorter attendance, sitting near an exit, attending with a support person [synthesis].
    5. For clients with religious trauma or after leaving a high-control community, do not assume prayer is a resource; let them define it [synthesis].
    6. Cheetah House offers consultations and professional training on meditation-related difficulties [source: Cheetah House VCE].
  • Example language (illustrative): "You can choose whether your name is said, and where you sit. We can also practise what to do if it gets too much."
  • Watch for: dissociation, panic, intrusive memories during services. Working: the client can take part, or decline, from choice rather than fear [synthesis].

4.12 Distinguishing spiritual experience from illness

  • Purpose and when to use: when a client reports unusual experiences around prayer (sensing a presence, conviction of a special healing role, voices) or intense despair after unanswered prayer.
  • Steps:
    1. Explore the experience within the client's tradition; ask how their community would understand it [synthesis].
    2. Assess for psychosis, mania, depression and dissociation using standard methods, without pathologising normative belief [synthesis].
    3. Where the focus is a religious or spiritual problem rather than a disorder, DSM-5-TR provides a code for it (Z65.8) [source: ICD-10-CM Z65.8].
    4. With consent, consult their rabbi about whether the experience is normative in their community [synthesis].
  • Example language (illustrative): "In your community, how would people understand what you felt during the prayer?"
  • Watch for: beliefs that one's own prayer alone will cure, linked to stopping treatment; these call for psychiatric and medical review [synthesis].

4.13 Role boundaries and the therapist's own commitments

  • Purpose and when to use: throughout, and especially when a client asks you to pray for them, to name them in your own synagogue, or asks your beliefs.
  • Steps:
    1. Reflect on your own religious or secular commitments and how they colour your responses; Vieten et al. propose attitudes, knowledge and skills competencies for this [source: Vieten et al. 2013 abstract].
    2. Decline roles that create dual relationships (acting as the client's prayer leader, adding them to your congregation's list, attending their synagogue as a member) unless carefully considered and documented [synthesis].
    3. Self-disclose only briefly, for the client's benefit, and return to their experience [synthesis].
    4. Refer to clergy for religious roles (4.9).
  • Example language (illustrative): "I'm moved that you'd want me to pray for you. My part is here with you; your rabbi or community can hold that part. How would it be to ask them?"
  • Watch for: the client idealising you as a spiritual authority; your own discomfort leading you to avoid the topic. Working: the client feels respected without confusion of roles [synthesis].

4.14 When prayer and medical care pull apart

  • Purpose and when to use: when the client, a family member or a group suggests prayer could replace treatment, or the client feels guilty that needing medicine shows weak faith.
  • Steps:
    1. State plainly that therapy supports their prayer life and that medical decisions belong with their doctor [synthesis].
    2. Note, if helpful, that their own tradition's teachers honour physicians and distinguish curing from healing [source: Barth/JTS; Cutter].
    3. With consent, coordinate with the treating doctor; consult the client's rabbi on any religious question about treatment [synthesis].
    4. Where a child or a person lacking capacity is at risk from refused treatment, follow your safeguarding procedures [synthesis].
  • Example language (illustrative): "Your rabbi talks about doctors curing and community healing. It sounds like you want both. Can we look at how to keep both going?"
  • Watch for: missed appointments or stopped treatment. Working: treatment continues and prayer supports rather than replaces it [synthesis].

5. Handling problems

The sources give little on problems in therapy; the guidance below is largely [synthesis] except where tagged.

  • Client stuck in "the prayer failed". Slow down; hear the disappointment before any reframe. Explore the struggle (4.6) and offer a rabbi or chaplain for the theological question [source: Pargament et al. 2001 via ReliasMedia]. Offer the curing/healing distinction only as their tradition's teachers frame it, and only if it fits [source: Cutter].
  • Resistance to discussing religion. Respect it; note that it is available later. Some clients fear judgement, others have religious trauma. Do not push spiritual content into therapy [synthesis].
  • Overwhelm in services or at the hospital bedside. Use grounding and choice (4.11); agree in advance how the client may step out or skip being named [synthesis].
  • "Non-adherence". There is no homework to adhere to. If the client stops praying or attending, explore the meaning (anger, exhaustion, depression, changing belief) without treating it as failure or as recovery [synthesis].
  • Rupture over beliefs. If the client senses you doubt the prayer, or think it is only symbolic, acknowledge it, repair, and return to their framework; avoid debating efficacy [synthesis].
  • Pressure to state that prayer heals. Neither endorse nor dismiss. You may say the research is equivocal (Cochrane 2009) if asked directly, while affirming the prayer's meaning to them [source: Cochrane; synthesis].
  • Prayer used in place of treatment. Follow 4.14: name your concern, keep medical care central, coordinate with the doctor, and use safeguarding procedures for children or people without capacity [synthesis].
  • Family or community conflict over naming. Some family members want a name read; the person may not. The RA guidance gives the person's own consent priority, with a loved one deciding only when the person cannot [source: RA study guide]. Help the client negotiate this.
  • Stigma about mental illness on the list. Note that the RA guidance explicitly includes people with mental illness [source: RA study guide]; help the client decide on disclosure (4.4).
  • Scrupulosity escalating during illness of a loved one. Fear of harming the sick person by error can intensify compulsions; begin ERP gently, with rabbinic consultation and the client's consent [source: IOCDF, Siev; synthesis].
  • Client asks you to pray with or for them. Hold the role boundary warmly; refer to clergy (4.13, 4.9) [synthesis].
  • Misconduct or coercion by a religious leader. No documented misconduct associated with this prayer was found in the sources consulted. If a client describes pressure by a leader or group (for example demands for money for healing, or to stop treatment), explore coercive control, support the client's autonomy, and follow safeguarding and reporting duties [synthesis].
  • Unusual experiences or rising despair. Assess as in 4.12 and use standard suicide risk assessment where indicated [synthesis].

Sources

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