The following comes from a discussion between His Eminence Metropolitan Hierotheos of Nafpaktos and Agiou Vlasiou with seminary students from the Moscow Theological Academy at Saint Sergius Lavra.
Question: How many times a year should someone receive Holy Communion? Is the Mystery of Confession necessarily linked with Holy Communion?
Answer: Holy Communion is not absolutely connected with Confession. In the ancient Church the people had the Grace of God within them, their nous was illumined and of course they prayed and communed frequently. When someone committed a sin, this meant that they lost the Grace of God, so they remained outside the temple and went to the place reserved for the catechumens. For someone cannot have the Grace of God and deny Christ. When someone sins, especially a carnal sin - and I don't mean the relations between those who have been married in Christ -, it shows that they prefer carnal pleasure over Christ and therefore they deny Christ in their actions. This lowers them to the stage of the repentant and they should after a process reach once again to the illumination of the nous.
In Basil the Great and other Fathers we see that there were four stages of Christians. The first were the Weepers, who sat outside the temple and asked forgiveness from the Christians who were entering. Second were the Hearers, who waited until the readings of the Divine Liturgy and then exited with the catechumens. Third were the Co-Standers, who remained within the temple until the end of the Divine Liturgy without receiving Communion. The fourth were those who communed of the Immaculate Mysteries. So, when someone committed a sin, they had to go through a period of repentance, and repentance meant for a person to pass through purification to the illumination of the nous, to change their darkened nous and make it bright. Afterwards the Bishop reads a prayer and the person could commune.*
This is why I say that Holy Communion is not absolutely connected with Confession. If someone commits a sin and requires Confession, then they should confess. If there are some sins, the so-called forgivable sins, then they are forgiven through the Service of Preparation for Communion and with the prayer "forgive us our trepasses as we forgive those who trespass against us", which is contained in the "Our Father".
Holy Communion should be seen in this context, because for some Holy Communion becomes Light and for others it becomes fire.
The Holy Fathers say that when we put two objects, such as mud and wax, under the sun, then the rays of the sun harden the mud and melt the wax. Yet the energies of the sun are the same, though the objects are essentially different, which is why they have different results. In the same way, God and Holy Communion for some is Light and for others they become fire.
In the churches of Monasteries there is depicted the icon of the Second Coming. At the top section is the throne and from the throne comes the light that illumines the saints and from the same throne comes the river of fire that consumes sinners. Isaac the Syrian says that Hell is the whip of God's love, which the love of man cannot fathom, because their heart is impure, unhealed. God loves the righteous and the sinners, but not everyone will understand God the same way.
Basil the Great wrote that light has two energies: the illuminating and the caustic, and as such, it illuminates and it burns. Whoever has eyes will avoid its caustic energy and will enjoy the illuminating energy of the light. Those who have no eyes to see, will accept the caustic characteristic of the light. That is what will happen during the Second Coming: the righteous will perceive God's Light and sinners will perceive His fire.
The exact same thing takes place during the Divine Liturgy. Some receive Holy Communion and are illuminated, while others receive Holy Communion and are condemned. The Apostle Paul says in his Epistle to the Corinthians: "For this reason, there are among you many who are weak and sick, and a great many are reposed" (1 Cor. 11:30). That is why the work of a priest is not to distribute tickets so that people might enter Paradise; he must heal people, so that when they encounter God, God will become Light and not fire to them.
We must clarify at this point the question of how frequently a healthy person and a sick person can receive Holy Communion; for example, a paralyzed person. It appears that a healthy person has many more sins and a paralytic does not have as many. But that is not correct. It does not mean that a healthy person sins and a paralytic doesn't. Sins are committed with one's thoughts and one's desires as well as with the body. One can be healthy and spend all day glorifying God and live an angelic life, and the other - a sick person - can live with faithlessness and indignation. What is important is for one to glorify God - whether in health or in sickness.
* According to St. Basil the Great: "The station of weepers is outside the doorway of the oratory, where the sinner has to stand and beg the faithful who are passing in to pray for him. The station of listeners is within the doorway in the narthex, where the one who has committed a sin has to stand until the catechumens pass out thence. For 'while listening', it says, 'to the Scriptures and the teaching, let him be put outside and not be allowed the right to participate in prayer.' The station of kneelers is within the doorway of the temple where the kneeler stands in order to go out together with the catechumens. The station of co-standers is that in which one stands together with the faithful and does not go out together with the catechumens. Last is the place where the consecrated elements are received."
Source: Ekklesiastiki Paremvasi, "Θεία Κοινωνία καί Εξομολόγηση", February 2010. Translated by John Sanidopoulos.