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Confabulation 

After experiencing a brain injury or other neuropathologies, an individual might develop a memory disorder that creates false memories called confabulation. These false memories that are being reported are purely unintentional and the individual has no recollection that these memories did not truly take place. Often, it is an unintended way to fill in the gaps of their memories. The individual could confabulate about events that never happened, create questionable stories about themselves or their whereabouts, or combine past events with recent ones. The individual will speak about these memories with such descriptive details that would make it appear to the listener as if it occurred. This type of memory problem is what some professionals would call “honest lying” due to the fact that people with confabulation issues truly believe in what they are reporting. This can make receiving professional treatment challenging, especially when receiving feedback about their false reports. In severe cases, confabulation can lead to being unable to live independently and needing supervision due to the individual’s poor insight, resulting in caregiver burden.  

Self-enhanced Confabulation 

A study in 2007 conducted by Fotopoulou et al., found that individual’s confabulations tend to demonstrate a more positive self-representation of themselves than their real memories, unintentionally. This suggests that although confabulations are a result of cognitive dysfunction, emotional factors could play a role in the memories that are being formed, especially in their autobiographical memories. Autobiographical memories allow individuals to construct a timeline of their personal experiences and have a continuous recollection of their sense of self in time. These memories and representations of themselves are a result of their mental abilities and some form of motivational factors (benefits of being represented positively). After a brain injury, both aspects can become distorted. Previous case studies have also reported spontaneous confabulations to feature a positive emotional bias, focusing on the positive aspects rather than the negative. Cases can differentiate depending on the individual’s premorbid personality and behaviors and how they dealt with previous stressful experiences. It can also be a way for individuals to unintentionally escape their current reality and cope with any unpleasant views of themself. 

Common Questions on Confabulation  

  • When does confabulation occur? 
  • It can occur spontaneously or proved by asking the individual a questions 
  • Are there different types of confabulation disorders? 
  • Confabulation types can be classified as a verbal or behavioral confabulations 
  • Verbal confabulation: Creating false stories such as going to an amusement park yesterday 
  • Behavioral confabulation: behaving in response to a false memory such as packing your clothes for a trip you that is nonexistent 
  • What are examples of what confabulation would look like? 
  • Confabulation can happen in many different ways: 
    • It can include fabricated details of new events 
    • It could be a combination of past experiences mixed with new events (such as the timeline or order), or a completely made up experience 
    • It can be an exaggerated story of actual events that occured 
  • Confabulations stories could sound realistic or like a fantasy with unrealistic details 
  • It can be a way to fill gaps within their memories 
  • Strategies to help someone with confabulation: 
  • Avoid confronting or offend the individual of “lying” 
  • Be gentle about this condition 
  • Professionals such as speech therapists, occupational therapists, or psychologist can teach the individuals memory strategies to improve their memory 
  • Keeping a diary to keep track of events that happen daily and reflect on them 
  • Utilizing techniques to reduce stress (confabulation could be enhanced during stressful situations) 
  • Using mindfulness techniques and coping strategies to reduce stress and improve memory skill 
  • Seeking cognitive-behavioral therapy to provide strategies to increase the individual’s self-awareness and examine their confabulations 
  • Seeking psychotherapy to help the individual cope with the fact their memories are not fully accurate or exist 

Often times, confabulation can improve on its own during the recovery process of a brain injury 

References:

Fotopoulou A. (2008). False selves in neuropsychological rehabilitation: the challenge of  confabulation. Neuropsychological Rehabilitation18(5/6), 541–565.  

https://doi-org.westcoastuniversity.idm.oclc.org/10.1080/09602010802083545 

Neurological Recovery Blog. (2020). Confabulation after brain injury: dealing with false  memories following tbi. Flint Rehab.  https://www.flintrehab.com/confabulation-after-brain-injury/ 

Fotopoulou, A., Conway, M., Griffiths, P., Birchall, D., & Tyrer, S. (2007). Self-enhancing confabulation: revisiting the motivational hypothesis. Neurocase13(1), 6–15. https://doi.org/10.1080/13554790601160566 

 

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