What is James 5:16 saying when it says to “confess to one another?”

Let’s look at this verse in its context. Here’s the whole section: Is any one of you in trouble? He should pray. Is anyone happy? Let him sing songs of praise. Is any one of you sick? He should call the elders of the church to pray over him and anoint him with oil in the name of the Lord. And the prayer offered in faith will make the sick person well; the Lord will raise him up. If he has sinned, he will be forgiven. Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righteous man is powerful and effective. Elijah was a man just like us. He prayed earnestly 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 5:13-18. A number of points are being made by James as he concludes his letter: (1) Prayer should be our “first responder,” the way we react to all troubles. That’s why Paul encouraged: Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus—Paul, Philippians 4:6-7. Not only is prayer our voice to God but, having prayed, prayer can also be our path to peace, knowing that, in praying to God, there is nothing better that we could have done. (2) Happiness should be seen as a reflection of the blessing of God; as Paul said so well, And my God will meet all your needs according to his glorious riches in Christ Jesus—Philippians 4:19. Is there a better definition of happiness than living a life where all my needs are met? (3) The idea of being sick was also recognizing that illness may be a reflection of spiritual illness as well, in which case confession is a vital component of the healing. What is lost in the English is that the Greek word translated “sick” in verse 14 (“Is any one of you sick?”) does refer to being sick in the physical sense, but a completely different word is used in verse 15 (“And the prayer offered in faith will make the sick person well”), using a word that means, among other things, “to be wearied.” Some contemporary commentaries suggest this may mean discouragement. In either case, the prayers of the faithful may be used by God as parts of the healing process. Of course, it must be recognized that, for any prayer to be effective, as John wrote, This is the confidence we have in approaching God: that if we ask anything according to his will, he hears us—I John 5:14. What James does do is paint a very holistic picture of a person’s existence, showing that all the facets of our existence—mental, emotional, physical and spiritual—are tied to each other, making our physical health inseparable from our spiritual well-being. Therefore, confession is integral to whatever healing is necessary. In line with this is the part the body of believers can play in the overall health of other members of the body. Of course, the most obvious picture is of my having wronged somebody, and confessing that wrong to them. But another example as well: I recently had someone from our church family confess a struggle with sin. Now having confessed that issue to me, I am in a much stronger position to pray for that person, specifically focusing on the area in which that person struggles the most—hopefully contributing to their eventual, spiritual healing—which will obviously have ramifications in other areas of their life as well. That confession helped enormously in making my prayers more effective and in keeping me mindful to “pray for each other.”