Resentment is the “number one” offender. It destroys more alcoholics than anything else. From it stem all forms of spiritual disease, for we have been not only mentally and physically ill, we have been spiritually sick. When the spiritual malady is overcome, we straighten out mentally and physically.
The first thing apparent was that this world and its people were often quite wrong. ... We began to see that the world and its people really dominated us.
Our actor is self-centered—ego-centric, as people like to call it nowadays. He is like the retired businessman who lolls in the Florida sunshine in the winter complaining of the sad state of the nation; the minister who sighs over the sins of the twentieth century; politicians and reformers who are sure all would be Utopia if the rest of the world would only behave; the outlaw safe cracker who thinks society has wronged him; and the alcoholic who has lost all and is locked up. Whatever our protestations, are not most of us concerned with ourselves, our resentments, or our self-pity?
We had to ask ourselves why we shouldn’t apply to our human problems this same readiness to change our point of view. We were having trouble with personal relationships, we couldn’t control our emotional natures, we were a prey to misery and depression, we couldn’t make a living, we had a feeling of uselessness, we were full of fear, we were unhappy, we couldn’t seem to be of real help to other people ...
Reading the above Big Book quotations carefully, it is clear that the spiritual malady is a condition shared by humanity. It is a component not of alcoholism but of the human condition.
We need God to stay sober, to override the defectiveness of the alcoholic brain and provide a method of living to live by other than the alcoholic brain's faulty wiring.
So far so good. Why is the spiritual malady relevant? Because the spiritual malady represents rebellion against God. We cannot rely on God if we are playing God:
Selfishness—self-centeredness! That, we think, is the root of our troubles. ... This is the how and why of it. First of all, we had to quit playing God.
The spiritual malady is not a third part of alcoholism, and is not a third part of Step One. That's why it's not mentioned in Step One, is not described until Step Three, under the heading of why any life run on self-will will hardly be a success (with alcoholic drinking being just one of many examples of self-will), and is not even named until Step Four.
It is a key component of the problem, however, because it is the thing, in fact the only thing, that stands in the way of an easy and direct solution in the form of God-reliance.
The spiritual malady is the glass panel that we have to break before we can get to the emergency release button.