The writer makes the point to say they don't always notice when they are powerless, but they always notice when life becomes unmanageable.  When they feel insane, they are often trying to control outcomes or others.  Life becomes worse when indulging their ego and trying to get their own way.  The result is pain, frustration, and failure.  Once they accept powerlessness, and turn to their HP, they become spiritually teachable.  Sometimes we have to go through a struggle before we surrender and accept reality.  Progress not perfection.

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This reading speaks to me because this is my life.  I am making progress, I'm also more compassionate, and in addition I enjoy my life much of the time.  But being human means I will get caught in the alcoholic's trap, and it is entirely up to me to turn this around.  Yes I have to take responsibility to change myself, instead of dreaming about what ifs, as though I can change someone else.  And that's why I keep coming back, because I'm sure that I can't do this alone.