Have you ever known someone who loved to tell stories, and each time they tell the same story it gets grander? Take for example the movie, Big Fish, with Albert Finney and Ewan McGregor, where a very personable man told all sorts of tall tales, and although those around him enjoyed the stories they didn’t believe them – until at his death the characters he talked about in his stories appeared at his funeral.

There are many people who love taking center stage at a party and expanding on the truth to weave a tale and get attention. This person, however, usually knows that he is making up a big portion of the story. What happens when a person’s view of reality and fantasy blur and they get confused as to what is true and what is not? That is confabulation. 

Confabulation confuses actual memory with imagination, or a confusion of true memories that may not have occurred at the same time. It is an alternate reality, and the patient is not aware they are confusing facts from fiction. They find it difficult to draw a line between delusions and lying, but they are 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. Often they talk constantly, and usually about things they know nothing about. They tend to rationalize the irrational.

This may be fun in a social setting, but in real life it can be quite frustrating for those around them.

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 or repressed memory, where a normal individual would “suddenly remember” supposedly recalls 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 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.



Wikipedia – Confabulation: http://en.wikipedia.org/wiki/Confabulation

Memory Loss and the Brain – Confabulation: http://www.memorylossonline.com/glossary/confabulation.html

The Narcissist’s Confabulated Life, by Dr. Sam Vaknin: http://samvak.tripod.com/journal75.html

Confabulation and the Grand Narrative: http://www.youtube.com/watch?v=CEKZ1jTmnys