Step One "We admitted we were powerless over alcohol--that our lives had become unmanageable."

A number of words and phrases are used here to describe those ready to take this Step: "complete defeat", "bankruptcy", "absolute humiliation", "hopeless". These are similar to terms in the Big Book such as "failed" and "defeated". But a new term is introduced here that is now commonly used in and out of the rooms. Those who are truly desperate are termed "low-bottom cases", and are said to have "hit bottom". "Bottom" is not used in the Big Book in this way, though Dr. Bob is described in A Vision For You as having reached the "nadir of alcoholic despair". (Page 155) To accommodate those who had not yet lost everything, or who are "scarcely more than potential alcoholics", it is said that we need to "raise the bottom". Thus in recent decades people sometimes describe themselves as "high-bottom" or "low-bottom", indicating to what extent these individuals were still functional in society, and how much property and prestige had been lost while drinking.

By the time of the 12 & 12, having a sponsor is assumed. He or she is briefly described as relating the nature of the alcoholic malady in terms similar to those used at greater length in the Big Book chapter Working With Others. The alcoholic insanity or obsession leading to the first drink is explicitly linked to the phenomenon of craving described in The Doctor's Opinion for apparently the first time in the literature.

The sponsor explicitly details the inadequacies of will power in fighting this disease. In describing the progression of his own drinking history, he may be able to convince a relatively high-bottom person that the latter's habits show some of the same traits. Seeing the hopelessness of our situation, we are said to become "openminded to conviction and as willing to listen as the dying can be." Thus was born the now-common phrase "gift of desperation", and the path to Step Two made clear.