Confirmation or Chrismation is the second sacrament of Christian initiation. It is called Chrismation (in the Eastern Churches: anointing with holy myron or chrism) because the essential rite of the sacrament is anointing with chrism. It is called Confirmation because it confirms and strengthens baptismal grace. It is conferred by "the anointing with Sacred Chrism (oil mixed with balsam and consecrated by the bishop), which is done by the laying on of the hand of the minister who pronounces the sacramental words proper to the rite. These words, in both their Western and Eastern variants, refer to a gift of the Holy Spirit that marks the recipient as with a seal. Through the sacrament the grace given in baptism is strengthened and deepened. Like baptism, confirmation may be received only once, and the recipient must be in a state of grace (meaning free from any known unconfessed mortal sin) in order to receive its effects.