16 - Confabulations

Summary

Confabulations are inaccurate or false narratives purporting to convey information about world or self. According to the received view, they are utterances intent on ‘covering up’ for a putative memory deficit. Confabulations are said to vary in terms of ‘content’, ‘mode of production’, ‘duration’, ‘aetiology’, ‘form’, and ‘conviction’. According to content, a distinction is often made between prosaic and fantastic confabulations; and according to mode of production two types have been distinguished: ‘volunteered’ and ‘extracted by the clinician’. Although the dearth of published case series might suggest that confabulations are a rare occurrence, this may be the result of underdiagnosis. With regard to aetiological factors, amnesia, embarrassment, ‘frontal lobe’ damage, a particular subtype of ‘personality’, a dream-like event, and a disturbance of the self have been listed.

There has been little work on the linguistic, logical, and epistemological status of confabulations although the way in which they are dealt with in the medical and neuropsychological literature suggests that confabulations are considered by most as a form of propositional attitude (i.e. a belief); if so, the problem of differentiating them from delusions remains (Berrios, 1985). Lastly, on account of the putative heterogeneity of their narratives, personalities and neurobiology, ‘confabulators’ (i.e. the subjects who issue confabulations) constitute a motley group.

Historical analysis shows that ‘confabulation’ entered psychopathology at the turn of the century as a member of a set of concepts (that included delusion, fixed idea, obsessions, overvalued idea, etc.) dedicated to capturing ‘narratives’ of dubious content. This means that confabulation is not an autonomous concept but part of a ‘discourse formation’, i.e. it only has meaning within a given context.