Confabulation is a Confusion of True Memories

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When it comes to memory, confabulation is a confusion of imagination with actual memory, or the confusion of true memories. Confabulation is difficult to differentiate from delusions and from lying, but the person who has these memories is not lying or making up stories. They are generally quite unaware their memories are not true, and will argue with anyone who tells them they are lying.

The condition is defined as “the spontaneous production of false memories: either memories for events which never occurred, or memories of actual events which are displaced in space or time.” The memories could be extremely bizarre, elaborate, detailed, or simply a combination of actual happenings and imagination. They could range from alien abduction to having French toast for breakfast when in fact they had eggs.

Confabulation is not, however, a false memory, where a normal individual would “suddenly remember” supposedly repressed incidents from childhood. It is, in fact, a memory disorder that often occurs in patients who have sustained damage to both the basal forebrain and the frontal lobes — such as after an aneurysm to the anterior communication artery.

Not everyone who experiences confabulation has sustained brain damage, but it is usually the result of neurological or psychological dysfunction of some kind. Patients with “Korsakoff’s syndrome,” a form of amnesia caused by alcohol abuse or malnutrition, characteristically confabulate by guessing an answer or imagining an event and then mistaking their guess or imagination for an actual memory. Neurologically intact people can also be susceptible to memory errors or confusions due to psychological causes, but this is not the same as confabulation.

There is no know cause for confabulation, although basal forebrain damage may lead to memory impairments while frontal damage could lead to self-awareness problems which result in the patient having memory problems without being aware of it. For example: the patient who said they had French toast for breakfast may have become confused and retrieved a memory of yesterday’s breakfast. In this case his answer – and the memory it was based on – may have been quite accurate; the events simply did not happen at the time he claimed.

Confabulation sometimes goes away spontaneously over time, in other cases therapy could aid the patient in becoming aware of his tendency to confabulate and the incidents will taper off.

The act of confabulation could actually serve an important role in the patient’s life. They could heal emotional wounds, or to prevent ones from being inflicted in the first place. They prop-up the confabulator’s self-esteem, regulate his/her sense of self-worth, and prop up his/her self-image. They serve as organizing principles in social interactions. Human intercourse is built around such entertaining deviations from the truth. The distinctions between reality and fantasy are rarely completely lost, and deep inside the healthy confabulator knows where facts and fantasy stop.

This is Ron White, two-time USA Memory Champion , memory training expert, and memory keynote speaker.

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Wikipedia — Confabulation:

Memory Loss and the Brain — Confabulation:

The Narcissist’s Confabulated Life, by Dr. Sam Vaknin:

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