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One way in which they differ that comes to mind iitedmamely has to do with why many “process” addictions can be overlooked or underemphasized as compared to psychoactive substance addictions. When we are talking about basic human behaviors that many people engage in all the time (like eating, or having sex) concepts of what is normal/acceptable/excessive/unhealthy get murky and are subject to bias. I can see a clear contrast to common perceptions about normal/acceptable/excessive/unhealthy when we are talking about the abuse of psychoactive substances. I think one implication for treatment is increased education about how these types of addictions are actually similar so that for the client, counselor and larger community/culture the conversation can turn from “how much is too much?” to “how can we help you recover from this addictive disorder?” I also think that “process” addictions are sometimes approached with the kind of mentality that substance addictions were subject to decades ago. These behaviors are often talked about as though it is a simple matter of willpower. With that mind frame comes a lot of shaming. It was helpful for me to understand in the Carnes’ article how neuroscientific evidence shows that distinctions between the physical and the psychological are artificial. I have often heard people dismiss overeating or gaming as “just a psychological addiction” as though this is somehow less of a problem than a physical addiction to something. The Carnes’ article clarified that it does not take a chemical to induce the same effects in the brain that are linked to psychoactive substance abuse. What this means for treatment, I think, is that clients may need help coming around to recognizing behavioral addictions as “real” addictions needing treatment.