(St Paisios) would say: "Prayer helps the world so much when there is heartfelt compassion, of course. I do not feel someone else's pain when I am sitting comfortably crossed and have every comfort and convenience."
The Elder's prayer was accompanied by fasting, toil, prostrations, and most importantly, humility. He used to say: "We should ask humbly. I say: 'My God, I am a wretch. Have mercy on me, and the whole world too.'"[1].
He believed that he was responsible for others' suffering. "If I was holy," he said, "and God heard my prayer, they would not be suffering." In a letter he wrote, "The wretched Paisios is -- wretched. Thanks to him there are a lot of tired souls, because he did not gain Grace so he could help people in the name of God, when merely human methods are not enough".[2]
"We ought to understand," he said once, "that when a sick person does not get better, it is our fault, because Christ said that He gave us the authority to work miracles, but we do not do anything." He added, "What can I do Father?" People come looking for help, and I cannot help them. It is shortcomings that are to blame - they keep me from being a beloved child of God, and God does not hear my prayer.”
"St Paisios of the Holy Mountain", by Hieromonk Isaac. Pg 530
[1] I have added this to my rule. I think you should too. This simple prayer encapsulates the Orthodox mind when at prayer. Not fully understanding this mind is not an excuse to not say the prayer! May God help us poor wretches to pray! We should know we are wretches, but love for God and our neighbor should COMPEL us to pray! Why do we not do this? Perhaps it is because we pray haphazardly, having trouble “fitting it in” to our “schedule”, without fasting, or prostrations or fire in our belly?
[2] This sentiment also adds to an explanation of the Orthodox mind, hinted at in the prayer: “I am a wretch…” We are wretched, but we have love, even if it is poor. We must pray out of love, and with confidence – not in ourselves! – but in God’s mercy. The Orthodox man truly blames himself for the suffering of others. God puts people in our path every day, and we forget to pray, or pray diffidently, or even --being wretches -- judge a person or do not notice his suffering, and do not pray!