Gregory Bateson offers a suggestive account of how such a call motivates existential and epistemic change in his 1971 essay, "The Cybernetics of Self: A Theory of Alcoholism." (Psychiatry 34, No. 1 (1971): 1-18, reprinted in Steps to an Ecology of MInd (New York: Ballantine Books, 1972, pp. 309-337). There he contrasts the standard Western epistemology that opposes a self-sufficient subject to an external world with a "theological" model in which the self is understood to be a part of a larger whole. The former model, failing to acknowledge transcendence, makes resistance to alcohol a matter of will power; it is notably unsuccessful in treating alcoholism. The latter model, acknowledging transcendence, transforms resistance into an act of surrender to a more powerful being. As Bateson comments, "To be defeated by the bottle and to know it is the first ‘spiritual experience.' The myth of self-power is thereby broken by the demonstration of a greater power" (p. 313).
His analysis of alcoholism rests upon an epistemic shift in the thinking of the alcoholic. According to Bateson, the alcoholic at first sees himself caught in a classic Cartesian opposition between an inviolate self and competing other -- the self versus desire, the body, alcohol. The will power of the isolated self is challenged by the temptation of drink; the struggle to resist alcohol is a struggle of the will. The alcoholic, by definition, fails, repeatedly, in this struggle, but he fails not as a consequence of a weak will or of the overwhelming power of desire, but precisely as a result of his own strength. As long as alcohol is resisted, the will is strong; but the very strength of the will, in order to be maintained as strong, requires further challenge. Such challenge can only be provided by alcohol, by challenging oneself to take one and only one drink and then to resist taking a second and a third. But of course, once one drink is consumed, the desire to have a second and a third proves to be overwhelming, and the cycle of drunkenness, resistance, temptation, test, failure, and drunkenness repeats itself.
Bateson's insight was that the symmetric logic of schismogenesis, in which temptation is countered by resistance in an ever-increasing series of challenges, is transformed by the logic of Alcoholic Anonymous. AA performs logical judo, transforming the symmetric logic of increasing struggle into the complementary logic of mutual accommodation. The first rule of AA is that "There is a Power greater than the self." Once this Power is truly acknowledged, and once one understands that alcohol is one version of this Power while God is another, the possibility exists for cure. One can cease struggling against alcohol by acknowledging its superior strength; but one can be cured of alcoholism by surrendering to a different fount of superior strength, God.
Both alcohol and God are stronger than the alcoholic. The alcoholic's error lies in thinking that he is as strong as alcohol, and can resist it through an act of will. Once he acknowledges his own limitation, once he acknowledges the existence of greater powers than himself, then his surrender to them will not be understood as a sign of weakness but rather as an act of self-knowlege and inner strength. He must surrender, but to God rather than to alcohol.
Bateson's lovely argument is that what is required of the alcoholic is, at first, a shift in epistemology: "Notably, the change is from a incorrect to a more correct epistemology" (p. 313). Here I would disagree in that the shift does not happen in this way experientially. Rather than the shift occurring on the epistemic level, I would suggest that it is a shift in metaphysics from which an epistemic shift also results secondarily. Metaphysics precedes epistemology. That is, I believe that first one experiences one's own limited power not as a cognitive matter, but as a matter of lived-experience -- of job loss, of destroyed relationships, of the deterioration of personal health, of finances, and, ultimately, of the acknowledgement of the failure of will alone -- and then one comes to an understanding both that there is a Power greater than the self, and that surrender to this Power offers a chance at salvation.
In what way is it any different? In fact, "mad" is often more honest - than say schizophrenic - a term as meaningless or meaningful as "mad", that is used primarily to give the diagnosis "mad" a pseudo-scientific/medical authority. 
