Do you have a loved one or know someone who has memory loss?
When we hear the term memory loss, we sometimes also hear the word confabulation. What do these words have in common and how are they different?
Confabulations are unintentional ‘lies’ or, better said, mistaken beliefs brought on by an inability to remember the past clearly. Research has much to tell us about why this happens and to whom it happens.
It’s not uncommon for people to ‘forget”, sometimes it merely normal forgetfulness. After all, there are so many things we keep track of in our daily lives. The fact is, we have 60-80,000 thoughts running through our minds on a daily basis; it’s akin to a tape that is constantly running in the background. Therefore, we simply forgetful which day we made a particular appointment or where we last put our keys.
But, when a person is actually losing their memory, there are other factors that come into play, and that is a mental type of error known as confabulation. What is a confabulation, and is it just something that happens as you lose your memory? Do we identify confabulation with advanced age? Let us first look at what the science says about confabulation.
Confabulations, in their broadest form, are statements that reflect a distortion of one’s memories such that the statement is related to actual events but not an accurate reflection of what happened. Unconsciously made distortions if you will-people making confabulatory statements do not realized that they are essentially saying something that is untruthful. https://www.tandfonline.com/doi/abs/10.1080/02643290600694901
A scenario may be helpful.
Suppose I visit my grandmother. She greets me warmly, and over tea she starts to remind me of the last time I visited. That we took a walk around the grounds of her senior living community, looked at pictures of my mother as a child, and ate dinner in the dining room with a friend. That is not how I remembered it.
In actuality none of this sounds like the last visit I had with her. My recollection was that it was a short visit in the cold of winter when we would not have gone outside. It takes me some time to realize that she is either combining previous visits from me in her mind or perhaps remembering the last time that my cousin (with whom she sometimes confuses me) came to see her.
According to literature, this example highlights a couple of the traits of confabulations.
· First, they usually are based on experiences a person has actually had – a person is unlikely to confabulate an experience in a country they have never visited or one that includes people they have never met.
· Secondly, confabulations are typically pretty plausible events; I certainly have spent a handful of afternoons with my grandmother doing some of the things she described.
· Third, in this hypothetical example, my grandmother spoke without a hint of irony – she was not joking with me and fully believed in the memories she was sharing.
Two Kinds of Confabulations
Scientists have decided to distinguish between two different kinds of confabulations The first kind is called spontaneous confabulation – this is when somebody confabulates without any prompting. For example, a person with dementia might say, “I know we talked on the phone this morning” to a visiting loved one with whom they haven’t spoken in weeks. When their loved one disputes this, the person with dementia may become upset or confused because they genuinely believed in the memory that they were recounting https://www.nature.com/articles/nrn1179
People who spontaneously confabulate act on their inaccurate memories, whereas when people engage in the other kind of confabulation, called provoked confabulation, they usually do not https://www.tandfonline.com/doi/abs/10.1080/02643290600694901
Provoked confabulation happens when a person is asked about their memory of an event, and they give an inaccurate response. Perhaps because these confabulators have been given a prompt by someone else, they are less likely to become confused by the confabulation they have made, and also less likely to act on their inaccurate remembering.
At this point, you may be questioning how people end up confabulating. How do we end up inaccurately remembering the past?
There are a couple of different levels on which to consider this question. One thing that is clear is that confabulation means something is not functioning as it should in the brain, which could be the result of brain damage, a mental illness, intense stress or trauma.
While this tells us where the problems originate, it is not totally clear what exactly goes wrong along the way to result in confabulation. There are three main hypotheses that scientists have about confabulation.
What is a person who is confabulating thinking? An illuminating study showed that people with amnesia who are sometimes known to confabulate, are as good at accurately remembering things they heard in the last hour as people without amnesia are at remembering things that they learned a week ago. If you asked me what I was doing a week ago today, I would answer with plenty of conviction. I might make a couple of mistakes, but I would feel pretty confident about what I was saying. People who are confabulating are having a similar experience: they have done their remembering, not noticed anything abnormal about the process, and believe what they are saying https://jnnp.bmj.com/content/50/11/1482.short We can also think of confabulation as taking ordinary patterns of elaboration or invention to a much greater level. All remembering is both an act of retrieving what happened, but also reinterpreting it https://www.sciencedirect.com/science/article/pii/S1053811903007213Where somebody who does not confabulate might slightly exaggerate a memory to make it more entertaining or dramatic, that same tendency, thanks to atypical brain functioning, might be more exaggerated during confabulation.
Is confabulation lying? It is certainly a statement of something which is not true, but it is something that is fully believed to be true. When people confabulate, they generally do not know any better – they are simply recalling the past as best they can. In this sense, confabulation is ‘honest lying’. While it may reflect an unconscious desire to remember things accurately or to appear a certain way, it is not deliberate deception https://www.tandfonline.com/doi/abs/10.1080/13546800903374871
Confabulations are common in people with dementia, whose brains become less effective as they agehttps://www.tandfonline.com/doi/abs/10.1080/15294145.2007.10773535 A major aspect of dementia is the loss of memory, something of which the person with dementia may not be completely aware.Therefore, they are likely to confabulate with increasing frequency as their brain functioning continues to change.
You are probably more likely to be around other people who confabulate than to do so yourself. If somebody seems to be confabulating, try to take the pressure off them to remember everything right, since experimental research suggests that even people without brain damage or a psychiatric disorder can be manipulated into endorsing false memories.
https://journals.sagepub.com/doi/pdf/10.1111/j.1467-9280.1996.tb00344.x Confabulation is not limited to adults – people of all ages, with developmental disabilities as well as neurodegenerative conditions, can engage in this behavior.
Email Phyllis@phyllisaymanassociates.com If you would like to know more about how to support people who are confabulating or to receive The SeniorScape® in your inbox.