To the casual observer, it didn’t look like a significant exchange at all.  

“Would you like a receipt?” the cashier asked politely.  

“Yes, please,” Chaim responded.  

Chaim left the store, crumpled the receipt, and threw it in the public garbage can. 

That was it.  

But for Chaim, this was a great victory. 

Chaim had always been considered a people pleaser. He was reliable, committed, and especially sensitive to the needs of others. If a job needed to get done, or a favor would mean a lot, Chaim was the man for the job.  

As a student, Chaim’s performance had been quite the same - punctual, industrious, and responsible.  

After several highly productive years in full time post high school yeshiva, and now seeking to pursue a career, Chaim encountered a challenge for which he found himself woefully underprepared – independence. Suddenly lacking the clear directives of teachers, parents, and what “the guys were doing,” he frequently found himself lost in thought and indecision.    

Chaim’s ruminations about different career trajectories, imagining the different lives he could potentially lead and obsessively weighing their pros and cons, began to disrupt his days – and his nights. He struggled to sleep well at night. This, naturally, made him even more prone to ruminations during the day.                                                                                                                                                                                
Before long, Chaim’s indecision began to impact other areas of his life. He began to hesitate before making any decision of any meaning. He spent hours pondering to which restaurant he should buy his parents a gift certificate for their anniversary. He spent weeks agonizing about whether he should take a summer internship in the corporate world, or spend one last summer as a counselor in camp. He spent most of a night tossing and turning in bed while deciding whether or not to go on a second shidduch date with someone. 

The vacillating became progressively worse. Chaim spent ten minutes one morning debating with himself which type of cereal to have for breakfast. He stared at his news app for seven minutes deciding whether to read the world news or local news first.  

Concerned friends and family members occasionally asked Chaim if he was okay. He would usually assure them that he was. He never wished to inconvenience people with worries about him. Other times he would share his dilemmas with them. Sometimes they tried to help; others they offered sympathy. Eventually, they became impatient.  

One morning Chaim was driving to shul, but couldn't decide whether to make an immediate turn, or to turn at the next block. Suddenly frozen in an intersection, with his right blinker on but not making the turn, Chaim was hit by the car behind him. People had told Chaim to get help before. Now, he finally did.  

Chaim went to a therapist who diagnosed him with an anxiety disorder he described as chronic indecisiveness. As a student and friend, Chaim's anxious nature had actually been helpful at times. He had studied diligently, been careful to follow rules, and never hurt anyone's feelings. In the arena of decision making, however, his thoughtful cautiousness had become - true to its name - a disorder.  

In therapy, Chaim explored his past, his experiences, and his fears. While he felt relieved to understand himself and to talk about his struggles, Chaim wanted to learn techniques to make decisions more effectively as soon as possible. Chaim's therapist recommended a coach who was trained in the treatment of anxiety disorders.  

The coach explained to Chaim that the body informs us of impending danger with a release of adrenalin and cortisol. This is quite valuable when a car is whizzing by a little too close for comfort, or a bee is flying right at someone.  

When the body sends that very same signal in response to a perceived danger that is not commensurate with the actual danger - or isn't danger at all - that is an anxiety disorder.  

Chaim had been finding himself afraid to make a wrong decision. His body had been treating this concern as one of danger. The only way to avoid the danger - he had thought - was to consider the decision so well that he would be certain that he was making the correct decision. When this certainty could not be attained, he would continue to feel in danger, and ruminate furiously to try to solve it.  

Chaim's coach explained to him that a key to getting out of this trap was to train his body to realize that it was not in danger. The way to do this was to make decisions as his body protested. The less thought that went into the decision the more his body would protest - and the better it would be for him.  

Chaim and his coach created a list of decisions that didn't matter. These would be fertile ground in which to begin. Regarding decisions that do matter, they then came up with methods for considering and weighing options, and then deciding - without looking back. Chaim would need to be able to live with the uncertainty as to whether his decision was the absolutely correct one or not. Chaim's coach reminded him that his body would protest vigorously at times, and that this would be quite unpleasant in the moment, but that in the long run it would help him immensely.    

So when the day finally arrived, it was a great victory. Chaim hadn't thought at all about whether a receipt would be useful or not. When the cashier asked him if he would like one, he arbitrarily said yes. After leaving the store with the receipt in his hand, Chaim realized that he had no use for it. Rather than panicking, berating himself, or trying to undo it somehow, he just threw it out. A seemingly meaningless interaction was actually a great success.   

Rabbi Shmuel Reich AAPC is an ADHD life coach in private practice in Monsey, NY (remote coaching also available) as well as a rebbi in Yeshivas Ohr Reuven in Suffern, NY. He can be reached for coaching of individuals or couples, as well as for speaking or writing engagements, at rsreichadhdcoach@gmail.com or 646-262-8257.