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It is customary to say Tehillim to ask Hashem to heal someone who is ill. I want to know how this works.

One possible mechanism is that the Tehillim are the praises of Hashem which must come before a request to Him. In this mechanism, the prayer (Mi Shebeirach … ) which follows the Tehillim is most important.

Another possible mechanism is that the recitation of the Tehillim acts a merit for the sick person and through that merit s/he should be healed. In this case, one might think that a prayer would include words like “in the merit of the Tehillim we have recited”.

So, what is the mechanism and how does it link to prayers for the recovery of the sick person?

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  • A lot of Tehillim is direct prayer.
    – N.T.
    Jul 31 at 8:40

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You might like this explanation brought in Mishpacha from the Tzitz Eliezer, that aligns with your second option

The Rambam (Avodah Zarah 12) forbids using verses from the Torah as an incantation, condemning those who “make the words of the Torah into a cure for the body when they are really a cure for the soul.” However, he goes on to say that it’s permitted for a healthy person to read verses from the Torah or chapters from Sefer Tehillim “so that the merit of reading them will protect him and save him from difficulties and injury.”

Rav Eliezer Waldenberg, author of Tzitz Eliezer, elaborates on the Rambam’s explanation, commenting that when we say Tehillim for a sick person, we are, in essence, praying to Hashem that He should heal the person; we hope that by saying Tehillim the person’s merits will increase. This is similar to reading Tehillim for protection, which is permitted.

See also this related MY question.

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