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Saturday, March 11, 2023

Muhy­id­din, the 2nd former prime min­is­ter in corruption charges for kickbacks from bumi contractors Jana Wibawa; Good governance entails inclusivity


Tan Sri Muhy­id­din Yassin is the second former prime min­is­ter after Datuk Seri Najib Razak was charged in court.


 Muhy­id­din, who is Ber­satu pres­id­ent and Perikatan Nas­ional chair­man, was charged at the Ses­sions Court yes­ter­day with four counts of power abuse involving a total of Rm232.5mil in grat­i­fic­a­tion and two counts of money laun­der­ing involving Rm195mil.

Muhy­id­din, who is Ber­satu pres­id­ent and Perikatan Nas­ional chair­man, was charged at the Ses­sions Court yes­ter­day with four counts of power abuse involving a total of Rm232.5mil in grat­i­fic­a­tion and two counts of money laun­der­ing involving Rm195mil.

Najib was sen­tenced by the Kuala Lum­pur High Court on July 28, 2020 to 12 years’ jail and a Rm210mil fine after he was found guilty of seven charges of crim­inal breach of trust, money laun­der­ing and abuse of pos­i­tion in the Rm42mil SRC Inter­na­tional case in con­nec­tion with the sov­er­eign fund 1Malay­sia Devel­op­ment Bhd (1MDB).

RM300mil kickback claims that led to charges being filed

PETALING JAYA: The charging of Bersatu president Tan Sri Muhyiddin Yassin in court is linked to allegations that contractors had deposited RM300mil into the party’s accounts in return for projects.

The projects were part of the Jana Wibawa programme, which was set in November 2020 by Muhyiddin when he was the prime minister, to empower bumiputra contractors struggling during the Covid-19 pandemic.

Under the scheme, bumiputra contractors rated three to five stars were given contracts through direct negotiation.

They had to be approved by the Finance Ministry and Muhyiddin has pointed the finger at his finance minister then, Tengku Datuk Seri Zafrul Tengku Abdul Aziz, as the one who had approved the companies getting the projects.

Muhyiddin has also called the allegations “political slander” to smear his reputation as the eighth prime minister.

In February, the MACC froze Bersatu’s accounts and has since charged several individuals in court.

They included former Bersatu information chief Datuk Wan Saiful Wan Jan and Segambut Bersatu division deputy chief Adam Radlan Adam Muhammad.

They were alleged to have collected funds from the award of the projects.

On March 2, Bersatu treasurer Datuk Mohd Salleh Bajuri was remanded by the graft busters to assist investigations into the party’s expenditure.

Mohd Salleh was instructed to go to the MACC headquarters on March 1 to give a statement on payments by Bersatu to suppliers and vendors. 

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Good governance entails an inclusive approach

INTRODUCED in November 2020 during the administration of Tan Sri Muhyiddin Yassin, the Jana Wibawa programme was meant wholly for bumiputra contractors to help them cope with the devastating effects of the Covid-19 pandemic.

The Malaysian Anti-corruption Commission’s (MACC) probe into Jana Wibawa has revealed the shenanigans of the persons allegedly involved. According to Law and Institutional Reform Minister Datuk Seri Azalina Othman Said, there were 56 projects valued at Rm6.3bil under the programme. But that’s another matter.

It must not be overlooked that non-malay contractors were also affected by the Covid-19 maelstrom. Some were on the verge of bankruptcy too.

It is therefore regretted that the government of the day chose to implement a politically popular policy instead of one that promoted inclusivity and would have enhanced racial unity.

Prime Minister Datuk Seri Anwar Ibrahim, in enunciating the principles of Malaysia Madani, emphasised that the direction of the country must be guided by significant priorities that require an approach cutting across political, social, economic, environmental and technological aspects.

Good governance entails a more inclusive culture in promoting unity in diversity. It is hoped that the future will not look anything like the past.

- DR A. SOORIAN Seremban 

 

 

Prove it or I'll will sue, Guan Eng tells Muhyiddin

 

The gloves come off for Anwar | The Star

 

Gloves come off in Anwar-Najib face-off - Malaysiakini

 https://www.facebook.com/groups/284813046015575/permalink/998546917975514/?sfnsn=mo&ref=share&mibextid=VhDh1V

 

 

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Bersatu’s accounts frozen more than 2 weeks ago

 

 

Friday, March 10, 2023

Discard bad attitude first

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I REFER to the report “Eliminating single-use plastics by 2030 seen as an uphill battle” (The Star, March 6; online at https://bit.ly/3f5ppoo - see links below).

I am concerned about this repeated call for banning plastics because, whether we like it or not, humans now and in the future cannot live without it.

Single-use plastic materials are important in many human industries, including food, medicines, clothing, and cosmetics.

The root cause of plastic pollution is not the single-use plastics but human behaviour. Humans are throwing away plastic waste indiscriminately due to lack of education and conscience. They do not see that what they are throwing away will flow through the drains and rivers into the sea, where they can be consumed by marine life and then enter the human body as microplastics.

The plastic soups floating on the surface of oceans these days were generated by humans. They are destroying the marine ecosystem and will impact on humanity in the not too distant future.

The correct way to manage plastics use is to establish a holistic control mechanism in a circular economy.

Countries that have successfully managed the use of plastics did it by educating their young from kindergarten to primary school to use these products responsibly. Their children grew up with a strong sense of responsibility and conscience to save planet Earth.

Children must be educated with a well-designed curriculum to understand what plastics can do to destroy their environment and life.

At present, our anti-litter law is quite broad, hence legislation that specifically covers use of plastics is needed. This new law should include provisions requiring shopkeepers to place signs to notify all customers of the consequence of disposing plastics irresponsibly and also provide instructions on proper disposal of plastics.

Enacting a new law on extended producer responsibility (EPR), as proposed by the World Wildlife Fund for Nature (WWF), should also be seriously considered. Among the provisions of this law should be the collection of a levy from plastics producers and retailers. This levy could be parked under an environmental agency such as the Department of Environment, which should be adequately staffed with well-trained environmental ambassadors and enforcers who are deployed nationwide.

The department could use the levy to fund its operations, including installation of CCTVS at strategic locations such as back lanes of shops, known dump sites in industrial areas and construction sites.

The levy can also be used to finance or subsidise local councils to change from manual to robotic systems of waste management. Compared to manual systems, robotic systems can be mobilised 24/7.

The levy can also be used to subsidise the setting-up of plastics recycling facilities to separate the plastic waste according to their generic types (e.g. polyethylene, polystyrene, polycarbonate, polypropylene, and polyacrylates) and perform mechanical and/or chemical treatments to recover the plastics. Many existing plastics recycling facilities are conducting waste treatment using conventional methods that may be environmentally hazardous or generate more untreatable waste.

The levy can be used to assist such industries to upgrade to newer technologies such as robotic systems and mechanical recycling systems that are more environmentally-friendly.

It is important that a circular economy is enabled to benefit all parties– from plastics manufacturers to consumers, and recycling operators to the government. More new jobs could also be created.

My views may not be acceptable to the many who want to ban plastics, but I hope those who want a good quality of life without damaging the environment may benefit from them.

By IR MAX ONG Selangor 

(The writer is a Society for the Environment UK chartered environmentalist, and Institute of Materials, Minerals & Mining, UK chartered materials engineer.) 

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Eliminating single-use plastics by 2030 seen as an uphill ba

Eliminating single-use plastics by 2030 ... - The Straits Times

Eliminating single-use plastics by 2030 seen as an uphill ...

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Eliminating single-use plastics by 2030 seen as ... - Head Topics

 

 How To Handle Team Members with Bad Attitudes - 6 Tried & Tested Steps

 

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Change your negative thoughts and behaviours with CBT

 

  CBT can help individuals recognise and challenge negative thought patterns that are causing them distress. — Pixabay  Cognitive behavioral...


Wednesday, March 8, 2023

How Fake News Shapes World Order: Atrocity Fabrication and its Consequences

Atrocity fabrication – the invention and reporting of atrocities committed by an adversary without knowledge that they ever occurred – has a centuries-long history at the heart of propaganda and power politics as an effective means of moving public and international opinion. Its use can provide pretext for a range of hostile measures against its targets, transforming in the public eye wars of unprovoked aggression into wars of liberation of the oppressed, or turning blockades to starve enemy civilians into humane efforts to pressure abusive governments under the moralistic label of sanctions. As it plays a large and growing role in global conflict in the 21st century understanding atrocity fabrication and the consistent means by and ends to which it has been used has become crucial to comprehending geopolitical events in the present day.

This book elucidates the seldom explored but central role played by atrocity fabrication in eleven major conflicts from the 1950s to the present day: from Korea, Vietnam and Cuba during the Cold War to Iraq, Libya and the emerging Sino-U.S. cold war more recently. It highlights the many variations of atrocity fabrication, the strong consistencies in how atrocity fabrication is used, and the consequences it has for the populations of the targeted countries, The book demonstrates the roles played by media and both government and non-governmental organizations in misleading the public as to the actuality of these highly publicized events. The emerging trend towards this mode of action, and the deep implications this has for world order, make an understanding of its history particularly critical.

West uses ‘atrocity fabrications’ to demonize enemies

 



  • Horrific false narratives are concocted to create animosity towards rivals, says 500-page study from top University of London researcher
  • Technique has been used by West for more than a century, using “fake news” to shape world order
  • China has been a major victim, with “Tiananmen Square massacre” and genocide of Uyghurs as examples of events that never happened
  • Tales are spread by allegedly “independent” think tanks, NGOs and media firms, discreetly financed by the U.S.

U.S. GOVERNMENT BODIES working with the western media created a massive “atrocity fabrication” industry to discredit China and other perceived enemies of the west, says a stunning new book to be published next month.

Horrific tales of torture and genocide were manufactured to be spread by the press in a technique developed by western powers over decades to demonize countries including Vietnam, Cuba, North Korea, China, and others, says “Atrocity Fabrication and its Consequences: How Fake News Shapes World Order” by A.B. Abrams, a geopolitical specialist and academic based in London. 


The widely spread narrative talks of more than six million dead, but not a single documented case has been found.

This atrocity fabrications process has been used in numerous locations around the world over decades, but recently culminated in a dramatically fake genocide in Xinjiang – in which the allegedly genocided group, rather than being wiped out, actually expanded ten times faster than the population of the people alleged to be perpetrators. 


“One of the key objectives of Western efforts to fabricate the narrative of a Chinese genocide was to turn global opinion against Beijing and unite the international community behind the West in its confrontation with China,” the book says.

WORLD HAS BEEN MISLED


2010-2018 Source: Global Times

The astonishing 500-page study by A. B. Abrams of the University of London shows exactly how the world has been misled by a series of deceptive techniques, developed over many years: and how what we read about China and Iran and other places today is directly related to famously fraudulent news stories like the “weapons of mass destruction” in Iraq and the machine-gunning of students at Tiananmen Square, both of which were false stories from western intelligence sources published widely in the media.

“Xinjiang’s Uyghur population were the latest Kuwaiti incubator babies, the latest American civilians killed in Cuban terrorist attacks, the latest Filipino civilians brutalised by the Huks or Syrian victims of their government’s chemical weapons,” Abrams writes. “They were Park Yeonmi forced to walk across three mountains and bury her father, Iraqi dissidents fed live into human shredders, students run over by tanks in Tiananmen Square, or Libyan women raped by Gaddafi’s black African mercenaries.

“What all these alleged victims had in common was that the crimes against them were never actually committed but were very widely publicised to build narratives which furthered Western foreign policy objectives.”

[ Scroll down to read more of the present story, or click here for a report about what really happened at Tiananmen Square in 1989 to open in a new window. ] 

 

The real Xinjiang is no giant prison, but a place that attracts more than 10 million visitors a month. Image: Panoramio

Abrams’ superb work will be published next month [March 2023], but advance copies have been sent to the present writer and others. The book is described by top independent journalist Max Blumenthal as “a devas­tating exposé of the interventionist clique that has weaponized human rights in order to destabilize enemy nations and immiserate their populations”.

Frighteningly, the fake stories often end up triggering violence, creating very real harm to real individuals, and causing huge amounts of undeserved reputational damage to communities perceived as enemies of the west.

FAKE NEWS SHAPES GLOBAL THINKING

Abrams is a highly respected scholar, known for his superb research-led work into geopolitical relations, and his ability to see through the thick fog of media noise. In painstaking detail, with sources carefully cited, this new book tells precisely how the western world uses the media to shape global thinking by creating false narratives and weaponizing concepts such as human rights to demonize rivals. 

 

Xinjiang, a once poverty-stricken region, has seen its GDP more than double since 2010. Health ratings have climbed steeply.

How does the atrocity fabrication technique work? Hostile people in allegedly “independent” human rights groups discreetly financed by the United States government fabricate stories of grotesque atrocities which are widely circulated by the world’s biggest media, including the BBC, Reuters, and the New York Times.

Abrams traces the development of the atrocity fabrication technique over centuries in multiple countries right up to the present day, but in this article, we’ll take a deeper look at just one example: his analysis of the current narrative of “concentration camps” in China. 

 

China has raised Uyghur life expectancy to higher than that of many Western nations. Image: Unsplash

The north-western part of China is painted as the site of a horrific genocide, involving millions of people tortured or murdered in a massive network of camps.

For comparison, the notoriously massive Los Angeles County Jail, which covers a land area almost twice the size of the state of Delaware, holds about 19,000 prisoners. The media asks us to believe that China has jails for three to six million people: literally the size of small countries. New Zealand has a population of about five million.

But it’s abundantly clear to everyone who visits Xinjiang or just sees the constant flow of videos from that community on Chinese TikTok that there has clearly been no such event. Just like people everywhere, they post videos of themselves dancing, eating, partying, getting married, and so on. Nobody could live such normal lives if a huge number of members of their community were being tortured and murdered in concentration camps. The narrative is clearly fake. So where did the horror stories come from?

“These claims relied overwhelmingly on U.S. government-funded anti-China groups dominated by hard­line Uyghur dissidents with Islamist or separatist positions such as the World Uyghur Congress, the Uyghur Human Rights and Democracy Foundation and the Uyghur American Association,” the book says.

“These were all heavily funded by the U.S. Congress through the National Endowment for Democracy, which had been closely affiliated with the CIA since its foundation and tasked with carrying out overtly what the agency had formerly done alone and more covertly.” 

 

The CIA spin-off NED spends millions on anti-government groups around the world

THE INNOCENT ARE HARMED

What is really shocking is that the fabricating of atrocities often leads to harm for the innocent: the Chinese community, for example, is unfairly demonized worldwide as cruel and barbarous, while blameless Uyghurs in China have been made unemployable for no fault of their own. 

 

Jerry Grey: retired London police officer who moved to China was not scared to speak out for his new community.

Ordinary individuals who speak out are also targeted. Jerry Grey (above), a retired London police officer, spent time in Xinjiang and wrote an honest description of life in the province, debunking Western media allegations of death camps. “This is absolute rubbish – there are not a million Uyghurs in concentration camps, that is just total baloney,” he wrote. 

 

Canadian Daniel Dumbrill, outraged by the false coverage of the 2019 Hong Kong riots, has become a popular commentator.

Daniel Dumbrill (above), a brewer-turned-commentator, did something similar. “We’re expected to believe that the population of Uyghurs is being eradicated. It’s a ridiculous statement whether it is in a literal sense or even a cultural sense,” he said.

They and others like them were punished harshly for telling the truth. Many western reporters attacked these individuals as paid agents of Beijing in front of audiences of millions, without a scrap of evidence. “The BBC, for one, equat­ed such questioning of the Western narrative with ‘spreading Communist Party disinformation’ and strongly implied the need for policing to restrict such expats’ reach on YouTube and other social media platforms,” Abrams says in the book.

Ironically, Grey and Dumbrill were telling the truth free of charge, while BBC journalists collected fat salaries for spreading “news reports” which consisted of fabricated atrocities. 

 

UK state-financed BBC journalists attacked ordinary people who dared to say positive things about China.

HOW THE PROCESS BEGAN

It is fascinating to look back at how the process began in the case of the Xinjiang fabrications. The book notes that many countries had to find ways to deal with Islamist terrorists. (Most preferred not to follow the western response of invading the wrong country and causing large numbers of deaths.)

China’s efforts to deal with extremist Islamist terrorists were to implement deradicalization programs, a route also chosen by Indonesia and France. However, western media and governments chose to present the Chinese version as unique. “The Chinese pro­gram saw a metanarrative created around it by Western NGOs and media outlets that was very far removed from any verifiable real­ity on the ground, and was based on highly dubious and in many cases entirely fabricated source materials,” Abrams says.

This misrepresentation of the facts was used to provide excuses to attack China on economic and other fronts. “As China emerged as an unprecedentedly potent challenger to Western power, this narrative sought to vilify and provide pretext for hostile actions against it,” Abrams writes. 

 

Millions jailed? CHRD interviewed eight unnamed people and extrapolated numbers.

Journalists were encouraged to print horrific reports about a massive network of Nazi-like death camps for the “genocide” of innocent victims, using stories from groups such as the Network of Chinese Human Rights Defenders. The CHRD website presents itself as a group of Chinese individuals rising up within the Chinese nation; but in reality, it is actually based in the US and “is heavily funded by the U.S. Congress through the NED, re­ceiving approximately US$500,000 annually”, the book says. CHRD listed its address as the Washington D.C. office of Human Rights Watch, a similar group that weaponizes the concept of “human rights” to attack China.

RECYCLED METHODS

How did they fool so many people so well? Practice and long experience. In particular, the west recycled the same atrocity fabrication techniques they had used to demonize North Korea against China—specifically “using emotional but highly inconsistent female defector testimonies”.

For example, the BBC and CNN for days made their top story the tale of Tursunay Ziawudun, presented as a concentration camp survivor with nightmarish stories. You can’t read the reports without feeling hate bubbling up for the Chinese.

But for anyone who makes the effort to dig deeper, a problem quickly emerges: she has been interviewed many times, and told very different stories every time, with the accounts becoming increasingly extreme. In 2017 and 2018 interviews, she described her time in the detention center thus: “To be honest, it wasn’t that bad. We had our phones. We had meals in the canteens. Other than being forced to stay there, everything was fine.” She also said: “I wasn’t beaten or abused. The hardest part was mental.”

However, the BBC newsroom shockingly chose not to tell its audience about these earlier interviews, presenting only a very different horror-movie-like story that mysteriously emerged after she had travelled to the United States as a guest of a NED-funded NGO. In the new version, she was “removed from the cells ‘every night’ and raped by masked Chinese men, and that she was tortured, gang-raped and had her genitals electrocuted”. Her cell mates “disappeared”. 

 

This meme by the present writer compares the dramatic difference in her stories.

Many of these “torture-porn” stories presented as news reports by the BBC and CNN were so extreme that even anti-China campaigners expressed discomfort, and tried to distance themselves. “You cannot write a news story claiming systematic rape based on three eyewitness ac­counts, not all of whom are reliable,” wrote Gene Bunin, who runs the Xinjiang Victims Database. “You just can’t and the BBC should know better. Take that from someone who’s been dealing with testimonies 24/7 for the past two years now.” 

 

U.S. academic Ma Haiyun, a harsh critic of China’s government, admitted he could no longer even discuss whether the stories were true. “In the current political climate, if you publicly state that there is no genocide in Xinjiang, it will affect your reputation to the point where if I said this, half of my friends would cut me off,” he wrote. In other words, the truth could not even be mentioned, let alone debated, even by anti-China campaigners.

OPPOSITE OF A PRISON

A common argument was that there must be a genocide in China, because why else would the Chinese refuse to allow anyone to enter the area? The western media followed the CIA-founded Radio Free Asia’s line in presenting Xinjiang as a giant prison, a locked-off place filled with oppressed people. This was the opposite of the truth. More than 150 million tourists visit the region every year, mostly domestic visitors but with some foreigners, making it one of the world’s top tourist spots in terms of numbers of visitors. Many stay in Uyghur-run hotels and make a point of eating Uyghur foods.

Worryingly, there were clearly cases in which the western media did not just report a false narrative, but seemed to actively enable the deception of their own audiences. Abrams noted how an image showing the details of Tursunay Ziawudun’s passport created a problem for the new narrative she was pushing. Instead of investigating this crucial discrepancy, CNN reporters covered it up by blurring the key part of the image.

Abrams’ book also notes the real story behind the image of a large group of men used by the Guardian and almost every other media outlet to present Uyghur concentration camp victims. But, as this writer pointed out two years ago, it really shows a 2017 group of people in a rehabilitation center gathering to listen to a Muslim speaker. 

 

Misused picture shows people listening to a Muslim speaker at a rehabilitation center from 2017.

SERIAL DECEIVER REWARDED

What about all those pictures on Twitter of Uyghurs being horrible harmed or mistreated? To answer that question for one’s self, consider the case of Arslan Hidayat. This Australia-based anti-China campaigner’s standard technique was to take pictures of people in misery from anywhere he could find them and then re-label them as Uyghurs being tortured by Chinese, for mass diffusion on the internet. When confronted, he would admit that this type of falsification was common among activists such as himself—and then do the same trick again.

You would think that such a person would immediately have sacrificed all credibility. The opposite is true: he was quoted as a legitimate source by the BBC, the Guardian, CNN, AFP, Al-Jazeera, TRT WORLD, and numerous others. Today he has been rewarded for his skills in deception by being given a salaried position at Campaign for Uyghurs, one of many, er, “independent” anti-China propaganda groups.

Moral compass? What moral compass? Dear reader, keep reading. It gets worse.

HARMING, NOT HELPING

One of the most depressing reports in the book is what happened to Esquel Group, run by a popular family in Hong Kong. This company, one of the world’s most successful shirt makers, happily employed 400 Uyghur workers, and many so enjoyed working there that they become long term staff. It was the sort of win-win situation that gives business people a good name.

Yet the company was unfairly put on a blacklist of “slave labor” firms by the US Commerce Department. This made exports difficult, harming the company and its employees. “In response Esquel invited U.S. Commerce Department staff to visit the facilities in Xinjiang with free and open access but received no response,” Abrams writes. For Esquel staff, it was puzzling – it was as if their accusers didn’t want to know the truth. 

 

Spinning mill in Changji, northern Xinjiang. Image: Esquel

“When it [Esquel] subsequently invited independent labour audit specialists to visit the facilities in Xinjiang and carry out unstructured interviews with randomly selected Uyghur workers, every instance found no evidence of the forced labour or coercion being alleged by Western sources,” Abrams writes.

But what could be done? For all its talk of “rules-based order”, the western government-media machine ignores even the most basic concepts of right and wrong .

Other companies, seeing cases like this, simply stop hiring Uyghurs. When companies are punished for doing the right thing, firms take fright. Western media and government are literally making Uyghurs unemployable while pretending to help them. 

 

The media’s fake stories ended up harming businesses in Xinjiang by preventing exports.

OTHER VISITORS REACT DIFFERENTLY

 

Muslims who visit tell a different story

What will be the outcome of this difficult situation? In Abrams’ opinion, it is clear that the Xinjiang genocide narrative has been swallowed by western countries, but he notes the majority of the world’s population is clearly sceptical.

Numerous middle eastern and Asian countries have sent envoys to Xinjiang and come away satisfied by what they have seen. Nepalese ambassador Leela Mani Paudyal noted after her visit: “The vocational education and training centres in Xinjiang are not ‘concentration camps’ as described by some Western media, but schools to help those in­fluenced by extreme thoughts to eliminate the harmful thoughts and learn vocational skills . . . This anti-terrorism example is worthy of learning by many countries.”

ATROCITY FABRICATIONS HURT EAST AND WEST

In the long run, it is very clear that the atrocity fabrications of the west are harmful and divisive to everyone, whether the narratives are focused on Xinjiang, Tibet, or on other parts of the world. Western governments and media have put so much time and energy into their overblown atrocity tales that it will be difficult for them to backtrack to more moderate positions. As a result, it is inevitable that there were be a sharp drop in trust levels for western governments and media. 

 

Nightmarish stories create needless animosity.

“The significant investment the west’s information networks have put behind the Xinjiang fabrication, including assets such as Human Rights Watch, the BBC and RFA, means that pressing this narrative too far, and limited international receptivity to it, may well erode Western international credibility when commenting on humanitarian issues beyond a point of no return.”

Some might say that the mainstream media’s reputation is already beyond repair. Time will tell.

Abrams’ excellent book will be out in March. It is highly recommended. 

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The book can be ordered from the publisher by clicking this line.

The book can seen on Amazon US by clicking this line.

The book can be seen on Amazon UK by clicking this line.


 


 


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Change your negative thoughts and behaviours with CBT

 

CBT can help individuals recognise and challenge negative thought patterns that are causing them distress. — Pixabay

 Cognitive behavioral therapy is a form of psychotherapy that is based on the idea that our thoughts, feeling and behaviors are all linked.


Recently, I was approached to write about psychotherapy and its efficacy, rather than delving into matters concerning mental health policy and upscaling of services.

Therefore, I thought it was appropriate to write on this subject that is often spoken about, but about which little is actually understood.

Psychotherapy is a type of mental health treatment that involves working with a mental health professional such as a psychiatrist or a clinical psychologist, to identify and address psychological issues.

It can involve different types of interventions, such as cognitive behavioural therapy (CBT), psychoeducation and psychodynamic psychotherapy.

The goal of psychotherapy is to help individuals gain insight into their thoughts and feelings, develop healthier coping strategies, and improve overall well-being.

What is CBT?

The most popular type of psychotherapy is CBT.

It is a form of psychotherapy that helps individuals to recognise and modify thought patterns and behaviours that are contributing to their psychological difficulties.

CBT relies on the idea that our thoughts, feelings and behaviours are all interconnected, and that changing our thinking in certain areas can lead to positive changes in our feelings and behaviours.

An example of a CBT intervention for a patient would be to have them identify and challenge any negative thoughts or beliefs that may be contributing to their emotional distress.

The patient would learn to recognise irrational thinking and replace it with more balanced and realistic thoughts.

The therapist would also help the patient to become more aware of their triggers and how to take more effective action in managing difficult situations.

The core principles of CBT are:

Cognitive restructuring

This is the process of identifying and changing thinking patterns that may lead to negative thoughts and beliefs. 

Exposure and response prevention

This technique focuses on reducing the fear associated with thought patterns and behaviours by gradually exposing an individual to the source of their fear and preventing any reaction from occurring.

Behavioural activation

This technique encourages individuals to engage in enjoyable activities, even when they may find it difficult to manage their feelings.

Relapse prevention

This technique helps individuals understand how to maintain their positive changes and prevent a recurrence of old thoughts and behaviours that may contribute to mental health concerns.

There are many different types of CBT, including:

Cognitive therapy

This focuses on identifying and challenging irrational and maladaptive thought patterns to improve emotional regulation.

Dialectical behaviour therapy

This helps individuals learn to better manage intense emotions, self-harm behaviours and interpersonal relationships.

Rational emotive behaviour therapy

This helps identify irrational beliefs and replaces them with more adaptive, realistic thought patterns.

Acceptance and commitment therapy

This helps individuals become more aware of their thoughts and feelings, and encourages them to become more psychologically flexible and accept difficult experiences.

Mindfulness-based therapies

These help individuals become more aware of the present moment and develop a non-judgmental attitude towards thoughts and feelings.

Efficacy of CBT

Behavioural activation encourages individuals to engage in enjoyable activities, even when they may not feel emotionally up to it. — AFP 
Behavioural activation encourages individuals to engage in enjoyable activities, even when they may not feel emotionally up to it. — AFP

Several studies have found that CBT is effective in treating a variety of mental health conditions, such as depression, anxiety, insomnia, post-traumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD).

For example, a meta-analysis published in the Journal of Consulting and Clinical Psychology found that CBT was more effective than placebo in reducing symptoms of depression and anxiety.

One assessment review found that CBT was more effective than other forms of psychotherapy in reducing symptoms of anxiety and depression.

Another study published in the American Journal of Psychiatry found that CBT was more effective than antidepressant medications in reducing symptoms of mild depression.

CBT can be used to effectively address a variety of other psychological conditions too, including phobias, substance misuse, eating disorders, personality disorders, anger management, relationship issues and chronic pain.

CBT can also help individuals develop more effective coping strategies for stress, improving self-esteem and enhancing overall psychological well-being.

Limitations of CBT

Mindfulness techniques, where individuals become more aware of the present moment, are part of CBT. — dpa 
Mindfulness techniques, where individuals become more aware of the present moment, are part of CBT. — dpa

Although CBT is an effective form of psychotherapy, there are potential limitations and pitfalls to be aware of.

For example, it requires a high degree of commitment and effort from the individual in order to achieve successful outcomes.

Additionally, since CBT primarily focuses on changing thought patterns and behaviours, it may not be as effective in addressing any of the individual’s underlying emotional issues.

Moreover, some individuals may find the cognitive restructuring techniques employed in this therapy to be psychologically challenging.

Also, it may not be as effective for individuals in more severe mental health states, such as those experiencing psychosis.

Some have argued that CBT does not acknowledge the role of biological factors in mental health issues, and that it can be an overly-mechanistic approach.

Biological factors in mental health refer to the brain and body’s physical and chemical processes that contribute to psychological issues.

These include neurological, genetic, endocrine and biochemical pathways, such as neurotransmitters and hormones, which can influence thoughts, feelings and behaviours.

An example of this would be hormonal imbalances in medical conditions like thyroid disorders, causing psychological manifestations.

CBT is not as well understood as some other forms of psychotherapy, in part because it is a relatively new form of treatment.

Additionally, many clinicians lack the knowledge and skills to properly implement CBT, and this can prevent individuals from receiving evidence-based treatment.

Finally, there is a lack of adequate research and comprehensive training programmes that can help clinicians gain the necessary skills to effectively utilise this therapy.

In my clinical practice, I have often been asked two questions.

Firstly, if CBT can be started together with psychotropic medications.

And secondly, if CBT can be the only form of treatment in place of psychotropic medications.

CBT can indeed be given together with psychotropic medications.

The combination of CBT and medication is often the most effective treatment for many mental health conditions, including depression and anxiety.

Medication can help reduce the symptoms of the condition and CBT can help to address underlying causes of the disorder, such as negative thinking patterns, lifestyle choices and patterns of behaviour.

Because of this, CBT may not be an appropriate sole substitute for psychotropic medications in the vast majority of cases.

It is important that each patient’s individual needs are considered carefully when determining the best treatment plan.

Ultimately, it is best to discuss with one’s mental health therapist the method of treatment that is most suited for an individual’s needs, rather than insisting on a therapy that seems appealing.

The mental health needs of every individual is unique, and therefore, a customised approach should be preferred for the best outcome.

Prof Datuk Dr Andrew Mohanraj is a consultant psychiatrist, the Malaysian Mental Health Association president and Taylor’s University Impact Lab on Mental Health and Well-being director. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. 

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When men eat wrong

 

Monday, March 6, 2023

Obesity is more complex than just overeating , Not just fat

 In conjunction with World Obesity Day yesterday, we take a look at how the understanding of this condition of excess weight has evolved.

We need to avoid weight bias where we make the assumption that people are obese solely because of their own choices. — Photos: 123rf.com

For as long as she could remember, Jane had always been plus-sized.

As a child, her family doted upon her as she was never picky about food and would eat anything given to her.

In school, she was always physically bigger compared to the rest of her peers.

She was often teased by her friends for her body size, but she was constantly reassured by her family that she was just “big-boned”, just like the rest of her siblings and family members.

However, by the time she reached young adulthood, she started feeling more self-conscious about her body size and embarked upon multiple cycles of crash dieting and exercise regimes.

She successfully lost weight a few times; however, each time she lost weight, she would eventually lapse into bouts of uncontrollable binge-eating.

As a result, she constantly struggled to keep the weight off and would always gain back the weight she lost, if not more.

With time, she became resigned to the fact that she was probably fated to be fat for life.

This led to body image issues, self-blaming, and even clinical depression that negatively affected her life and relationships.

The scale of the problem

Jane is not exactly a real person, but her story is very real – a coalescence of the lives of many people struggling with weight issues everywhere.

The global obesity epidemic, aptly coined “globesity”, is arguably one of the most important public health concerns of the late 20th and early 21st century.

As of 2016, the World Health Organization (WHO) estimated that 650 million adults worldwide were obese.

According to the World Obesity Atlas, these numbers are expected to increase, with the global obese population projected to breach the one billion mark by 2030.

It is also no longer news to us that Malaysia is effectively the fattest country in the region.

The 2019 National Health and Morbidity Survey (NHMS) reported that one in two Malaysian adults were either overweight (30.4%) or obese (19.7%), and one in three Malaysian children were overweight (15.0%) and obese (14.8%).

On top of this, if we account for the rampant weight gain seen during the Covid-19 movement control order, the current true numbers of obese people in Malaysia is likely even higher.

Traditionally, being overweight and obese has been viewed as a risk factor that increases an individual’s chances of developing metabolic diseases such as type 2 diabetes, hypertension (high blood pressure), cardiovascular (heart) disease, obstructive sleep apnoea, and musculoskeletal disorders such as osteoarthritis, among others.

This fact still very much holds true today.

However, in 2014, the American Medical Association declared obesity as a disease state in itself.

This actually had very far-reaching implications.

It effectively changed the way we view obesity – as more than just excessive fat deposition contributing to other diseases.

Obesity itself is now seen as a disease state that requires formal medical attention, proper treatment plans and prevention efforts.

The complexity of obesity

Experts worldwide have been calling for measures to be taken to curb this growing issue for decades, but the rates of obesity have continued to rise regardless.

The idea that obesity is a disease of the brain is gaining traction among scientists as the hypothalamus (in yellow) plays a key role in regulating our appetite and metabolism..The idea that obesity is a disease of the brain is gaining traction among scientists as the hypothalamus (in yellow) plays a key role in regulating our appetite and metabolism.>>

This is because obesity is a very complex issue with a lot of interconnected causes.

In the past, it was assumed that as our society became richer, we had to physically work less to get our food and this led to over-nourishment.

However, we now know that it is overly simplistic to think that obesity develops as a result of an individual just “eating too much”.

Instead, there are often multiple factors beyond our control that contribute to an individual developing obesity.

For example, people who come from disadvantaged socioeconomic backgrounds may not have the financial privilege of accessing healthy food options.

They may also not be educated enough to choose better quality food with their available resources.

Children born into these families with a history of obesity have higher chances of developing obesity later on in life.

This is partly contributed by genetic factors, as well as enduring lifestyle habits inculcated from a young age that may be difficult to change.

Obesity is also closely linked to the development of mood disorders such as depression and anxiety.

People suffering from depression also have a higher chance of developing eating disorders that subsequently lead to obesity.

A lot of these factors form vicious cycles that span generations.

On a population scale, we are living in an increasingly “obesogenic environment”.

This refers to the multiple physical, economic and sociocultural factors that collectively contribute to the development of an obese population.

For example, our built environment promotes a sedentary lifestyle.

Our roads are hardly pedestrian or bicycle-friendly.

Our public transportation system is not optimised, as the lack of last-mile connectivity remains a major hindrance for many.

As a result, most Malaysians are heavily dependent on motorised vehicles to get around, rather than walking or cycling.

Globalisation and industrialisation of the food supply chain have made ultra-processed foods more common now than ever.

Ultra-processed foods refer to those that have gone through a series of industrial processes, often with ingredients like high-fructose corn syrup, modified oils, food colouring and other additives to make the final product hyper-palatable.

These foods are commonly high in calories and easily over-consumed.

They are generally mass-produced and marketed by large companies, and are often much cheaper and more readily available compared to whole, nutritious food options.

As we start to understand more about obesity, it has become increasingly clear that it is, in essence, a disease of the brain.

The hypothalamus located in the brain plays a key role in regulating our appetite and metabolism.

The satiety centre in the hypothalamus is largely responsible for controlling our sensation of hunger.

When an individual develops obesity, the accumulation of excessive fat tissue actually leads to a host of hormonal changes within the body.

These hormonal changes not only suppress the satiety centre and increase hunger, but also slow down our metabolism rate.

Essentially, our body has a weight “setpoint”, and will try to revert to this setpoint despite our best efforts.

These underlying biological mechanisms are largely out of our voluntary control.

They also explain why people with obesity who embark on lifestyle changes to lose weight tend to hit a plateau after an initial weight loss.

In fact, after some time, they may regain some of the weight they lost initially.

Weight bias

The easy availability and affordability of ultra-processed foods is part of the obesogenic environment that makes it easy to gain excess weight. — TNS 
The easy availability and affordability of ultra-processed foods is part of the obesogenic environment that makes it easy to gain excess weight. — TNS

It is precisely because of these underlying complexities that we should be careful not to indulge in weight bias.

Weight bias, or weight stigma, refers to negative attitudes, beliefs and judgments toward individuals who are overweight and obese.

In other words, we have to avoid the over-simplistic assumption that people with obesity are the way they are as a result of their “poor life choices”.

This stigma is very common because body weight is a physical characteristic that is visible and is often the first thing we notice about a person.

Studies have shown that even doctors are guilty of weight bias.

These can range from explicit behaviours, such as outright fat-shaming and teasing, to implicit beliefs, such as seeing someone who carries excessive weight and immediately considering them to be lazy, undisciplined or unmotivated.

Shaming individuals with weight-related issues does not motivate positive behavioural changes.

Instead, it often leads to the development of unhealthy behaviours such as compulsive exercise, as well as eating disorders such as cycling between extreme fasting or dieting, and episodes of binge eating.

Worse still, when this becomes internalised, an individual believes that they deserve the stigma and discriminatory treatment because of their weight.

Internalised weight bias is strongly associated with unhealthy eating patterns, poor body image, low self-esteem and depression.

Striking a balance

Conversely, this by no means indicates that we should normalise obesity or dismiss the deleterious health effects associated with it.

Instead, an individual’s body fat excess needs to be objectively taken into context as one part of their overall health.

The body positivity movement promotes acceptance of all body types, shapes and sizes, and not assigning self-worth solely to outward appearances.

This need not be mutually exclusive with taking obesity seriously as a public health emergency requiring urgent attention.

Over the last few decades, there have been major advances in the medical treatment of obesity.

Bariatric surgery has long been proven to be very effective, but it comes with its own set of complications.

New medications have been developed to specifically target the hormonal changes in obesity and induce very effective weight loss.

However, these medications are still very expensive and may not be widely available.

It also does not take away the fact that prevention is still better than cure.

Once established, obesity is very difficult and arduous to treat due to the reasons explained above.

Preventing obesity requires a concerted effort.

Government policies need to be drafted holistically, keeping in mind that economic and structural development often have indirect population-wide health consequences in the long run.

The food industry needs to be regulated for responsible manufacturing and marketing practices.

Society as a whole also has a collective responsibility to recognize that obesity is a disease and consciously adopt a healthy culture to address and prevent it.

The theme for World Obesity Day 2023 is “Changing Perspectives: Let’s Talk about Obesity”.

It is apt that we keep the conversation going, correct misconceptions, end stigma, and collectively shift towards a rational and sustainable strategy to tackle this perennial issue.

Dr Lim Quan Hziung is a lecturer and internal medicine physician training to become an endocrinologist at University Malaya. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. 

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