"Epitimia" or penance is to be understood as an interdiction which, according to Church canons, the priest as a spiritual physician may apply in certain cases in order to treat the moral diseases of his spiritual children.
The Canons contain many recommendations for sins such as murder, adultery and other sins of the flesh, and many other circumstances. Most of these specify a certain period of time when the penitent is barred from receiving Holy Communion.
An Epitimia need not only be a prohibition from receiving the Holy Mysteries. A confessor might impose a fasting beyond that which others do, some additional prayers of repentance, performing of a certain amount of prostrations, works of mercy, reading of the Holy Scripture and other righteous exercises.
A special penance or Epitimia imposed sometimes by the priest-confessor is not a punishment but represents an action for correction or pedagogical healing. The purpose is to deepen contrition for sinning and to support the will for correction.
The Apostle Paul said, "For godly sorrow produces repentance to salvation, not to be regretted; but the sorrow of the world produces death" (2 Corinthians 7:10).
One of the canons of the Sixth Ecumenical Council declares: "Receiving from God the power to bind and loose, the priest must evaluate the nature of sin and preparedness of the repentant, and thus utilize appropriate means of healing. But if not applying appropriate means to this or the other, salvation will not be available to the sinner. For all sins are not similar, but different and specific, and represent many aspects of harm from which evil develops and disperses further, unless it is stopped by the healing power."
In our pitiful days, when Christians wallow in ignorance about righteousness, and society teaches them to be ever more self-indulgent, the wise confessor gives out Epitimia with a gentle hand. It is important to not snuff out the small flame of contrition that burns in a penitent by dispensing an Epitimia that may be very appropriate for a more spiritually mature person, but would only be perceived as a punishment to someone who can barely tolerate spiritual milk.
Edited, with several additions, from http://www.fatheralexander.org/booklets/english/penance.htm#aid
As a pastor, Elder Ambrose had a gentle approach, which some mistakenly interpreted as weakness.
"Once," writes Archbishop Anthony, "not understanding, I said to him after confession, 'Why, Batiushka, you are not even giving me an Epitimia.' He meekly replied, 'You know, I have observed for myself that a kind word acts with more strength than anything else.' "
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