Confabulation: About, Examples, Causes and Treatment

Confabulation refers to a situation where a person has gaps in their memory which are then unconsciously filled with information that has been misinterpreted, is distorted or completely invented.

While there is a total lack of evidence to suggest the truth of a confabulator’s belief, they refuse to believe it is incorrect.

This is an interesting concept which is closely linked to multiple areas within mental health – including the topic of memory.

Background

Confabulation and lying are commonly believed to be the same. However, there are many differences between them.

While lying generally involves a conscious decision to deceit, confabulation is a genuine memory of a person who has no reason to doubt its existence.

Moreover, the confabulation has happened unconsciously. It therefore has the term “honest lying” sometimes applied to it [1].

Confabulation may also be likened to delusions. However, delusions are more related to false beliefs, rather than false memories. Delusions are commonly seen in conditions like delusional disorder, schizophrenia and schizoaffective disorder.

An example of a confabulation could be when someone is asked to talk about a past event that they partook in, for instance a birthday party. They may not remember what they did at this party, so they confabulate a story that may make sense in what happened.

Another example would be a person who had a bruise from falling off a ladder. The person may wake up and forget about the incident, and concoct a confabulation suggesting they were attacked by someone, which explained the bruise.

Typical Signs

There are usually a few distinctive signs associate with confabulation:

• The person fully believes what they are saying, and make no attempt to lie
• The person doesn’t realise that their memory isn’t true. Even when faced with information to doubt its existence, the person refuses to accept this.
• Often, their memory will seem very articulate and appear to be feasible
• It is also possible for their memory to be completely bizarre, unstructured and difficult to understand.

Relation to False Memory

The topic of memory is one of the most controversial in psychology. Confabulation can be classed as a false memory.

In the past, it is believed that false memories have been inadvertently implanted by therapists, which are then “recovered” through therapy.

This has led to accusations of past abuse being levelled at innocent parties. But there is an ongoing argument regarding whether or not memories uncovered in therapy can be trusted.

Therefore, confabulation forms part of this subject. They are closely entwined with the idea of “false memories”.

The Science

Confabulations often occur as a result of brain damage, mental illness, memory disorders or a neurological disorder.

Brain damage can affect areas of the brain that are responsible for storing memories. This is also the case in memory disorders like Alzheimer’s Disease.

A neurological disorder named Wernicke-Korsakoff Syndrome can also cause confabulations – this condition is linked to long-term alcohol abuse.

In terms of the areas of the brain that are impacted, it is believed lesions in the frontal lobe can cause problems in the processing of memories. This subsequently affects other areas of the brain. The exact mechanism that involves supposedly false memories being created isn’t clear.

Association with Mental Health Conditions

Confabulation is generally associated with Dissociative Disorders, particularly Dissociative Identity Disorder – previously known as multiple personality disorder.

Any head/brain injury may also lead to confabulations. Additionally, confabulation can be a symptom of either Schizophrenia or Bipolar Disorder – though this is rare [2].

How is Confabulation treated?

If confabulations are causing problems in life for a person, it may be advisable for the situation to be treated.

Confabulations can normally be treated through a form of talking therapy. There are a range of types of talking therapy.

Cognitive behavioural therapy is an example of a form of talking therapy that can help with this, as it helps a person come to terms with their cognitive processes, thoughts and the impact they have on behaviour.

It is difficult for anyone with a confabulation to be told their memories are false. But over time treatment can be used, with the aim of helping a person return to a state of mental wellbeing.

Summary

Confabulation is a complex topic, and one that will continue to be researched. It crosses-over with several elements of mental health.

Its connection to false or recovered memories is important – and helps to explain how some may have erroneously accused others of past abuse, due to a confabulation.

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