When I hear this part of the book, I think about the highly narcissistic person who can never admit they have a fault of any kind. I've actually known someone who was like this, and an alcoholic, and her alcoholism did kill her.
She was highly educated and hated the idea of turning her will over or believing she was powerless over anything. The thought of doing the twelve steps was actually disgusting to her. It was clear to those who knew her that she was her own worst enemy, but she could never see it.
She tried to detox at home, and died on the third day. Because she didn't trust doctors and knew better than they did what she needed.