Delay of Game on Pitcher?

[cshs81]

Originally Posted by SAump

From BRD 355 Failure to Pitch with Batter in Box
Pitcher delays with or without runners
FED 6.2.2c failing to pitch or make or attempt a play, including a legal feint, within 20 seconds after he has received the ball.
Penalty: The batter shall be awarded one ball. {Didn't find 6.1.2a, 6.2.2e and 6.2.2f in my older FED book}

I missed the part about "with or without runners" the first time I read it.

Isn't the pitcher dependent upon the batter to go through his pre-swing gyrations and getting signals? If so, how do you enforce the 20 seconds?