INBOX: ADD – Attention Davening Disorder, A Lighthearted View of A Serious Problem

I came to the realization rather late in life that I suffer from ADD – Attention Davening Disorder.

Looking back, the symptoms had been there for years, but like many chronic conditions, I had learned to live with them without giving them a name. Once diagnosed, however, I began paying more attention to the condition itself: the symptoms, the triggers, and, most importantly, possible treatments.

In the interest of helping others who may be quietly suffering from the same disorder, I thought I would share what I have learned.

Stigma

For many years, ADD carried a considerable stigma. Sufferers were reluctant to discuss their condition, fearing that others would assume that a wandering mind meant a lack of seriousness, commitment, or yiras Shamayim. As a result, many cases went undiagnosed.

More recent observational evidence suggests almost exactly the opposite: ADD appears to be remarkably widespread, including among otherwise sincere and committed daveners. In fact, one of the most reliable indicators of the condition may be how much it bothers you when you realize your mind has wandered.

The stigma is gradually lifting. Patients are beginning to speak openly about their symptoms, compare experiences, and admit the previously unthinkable:

“I have absolutely no idea what I just said.”

Symptoms

ADD presents differently in different people, but several symptoms appear to be common:

• You finish Shemoneh Esrei with no recollection of having started it.
• You suddenly regain consciousness at Modim.
• Your mouth is in Shacharis; your brain is already answering emails.
• You discover that apparently you have been saying Ashrei while mentally solving a completely unrelated problem.
• You have exceptional concentration during the announcements.
• You can remember exactly what the guy three rows over was wearing, but not whether you said Ya’aleh V’yavo.
• Your siddur is open to the correct page, which is the strongest available evidence that you were actually davening.
• You begin thinking about something during Pesukei D’Zimra and, several pages later, realize that you are still thinking about it.
• In more advanced cases, the patient may actually become annoyed when davening interrupts whatever he was thinking about during davening.

Diagnosis

The road to recovery begins with diagnosis.

ADD is frequently self-diagnosed. One simple diagnostic test is to ask the patient immediately after davening:

“What did you just say?”

A blank stare is considered clinically significant.

It is important, however, not to confuse ADD with not caring about davening. In fact, one of the most frustrating features of the disorder is that the patient may care very much. He wants to concentrate. He may even begin davening determined that today will be different.

And then, three minutes later, he is thinking about something that happened in 1997.

The mouth remains faithfully at its post. The mind has left the building.

Risk Factors

Certain conditions appear to increase the likelihood of an ADD episode:

Stress. Lack of sleep. Work. Family. Money. An upcoming meeting. Yesterday’s conversation.

Tomorrow’s problem. The person who just walked into shul. The person who didn’t walk into shul.

A noise in the hallway. A particularly interesting crack in the wall.

Smartphones are considered a significant aggravating factor, even when turned off. Apparently the brain does not require the actual phone once it has been properly trained.

Severe cases have also been associated with having something important to do immediately after davening.

Treatment

There is currently no known cure for Attention Davening Disorder, but symptoms can be managed.

Treatment usually begins with slowing down.

Patients are encouraged to select one small section of davening and attempt the radical intervention known as thinking about the words.

Trying to maintain perfect concentration throughout the entire davening may actually be counterproductive. A more realistic treatment plan might begin with one paragraph. One bracha. Even one pasuk.

Other therapies include following inside the siddur with a finger, arriving early enough that davening does not begin as the final stage of a frantic morning, and learning the meaning of passages that have become so familiar that the mouth can recite them without consulting the brain.

Closing one’s eyes has also been attempted, although this treatment carries a known risk of sleep.

Medication

For persistent cases, medication may be necessary.

The most commonly prescribed drug is Kavanah.

Unfortunately, Kavanah has an extremely short half-life and may need to be taken repeatedly throughout davening.

For acute episodes, some patients have reported success with Modim XR, which produces the sudden realization that one is standing before the Ribbono Shel Olam and perhaps ought to pay attention.

A few lines of Tanya are also known to reduce mental noise and provide an effective reset. They may be taken before davening and repeated as often as necessary.

No prescription is required.

No known risk of overdose.

Possible side effects of treatment include humility, gratitude, and the somewhat disturbing realization that you have been saying the same words for decades without ever really noticing what they mean.

Prognosis

The goal of treatment is probably not to reach a point where the mind never wanders.

Minds wander. Mine certainly does.

Perhaps the more meaningful measure is what happens when we notice.

There is a small moment when you suddenly realize: I’m somewhere else.

And then you come back.

Back to the siddur.

Back to the words.

Back to the One you are speaking to.

Maybe that moment isn’t evidence that the davening has failed. Maybe the returning is itself part of the avodah.

I still have ADD.

I suspect I always will.

But the road to recovery begins with the diagnosis – and continues every time the mind wanders and, once again, we bring it home.

— A recovering patient