What is Confabulation? Separating Fact from Fiction

Confabulation refers to a cognitive disorder that involves creating or inventing ‘memories’ that don’t actually exist. People who suffer from confabulation tend to fill in gaps in their memory with made-up stories and often believe their accounts to be true. In some cases, confabulation can be harmless, but it can cause problems when the person believes the false memory to be real, leading to confusion or alterations in their behavior. In this article, we will explore what is confabulation, what causes it, and how it is treated.

Types of Confabulation

There are two types of confabulation: spontaneous and provoked.

Spontaneous Confabulation

This type of confabulation occurs when someone unintentionally creates false memories. Spontaneous confabulation usually happens due to a brain injury or is a result of a memory disorder. In some cases, the person who has suffered from spontaneous confabulation may not even recognize that their memory is untrue, making it difficult for others to correct them.

Provoked Confabulation

The second type of confabulation is provoked confabulation, which means that false memories are created intentionally. The person often feels a pressure to fill gaps in their memory or create a narrative that supports their beliefs or desires. It is also a common occurrence in people with acute or chronic psychosis.

Causes of Confabulation

Confabulation can be caused by a range of factors, both psychological and physiological. Some common causes include:

  • Brain damage or brain injury
  • Memory disorders such as amnesia, Alzheimer’s disease, or dementia
  • Mood disorders such as depression, anxiety, or bipolar disorder
  • Alcohol or drug abuse
  • Sleep deprivation
  • Schizophrenia or other psychotic disorders

Features of Confabulation

There are some key features of confabulation that differentiate it from a genuine memory. Some of these features are:

  • The memory is often highly detailed and vividly recalled
  • The person is confident in their recollection, even when it is wrong
  • The story is frequently inconsistent
  • The person has trouble distinguishing between reality and fantasy

Diagnosis of Confabulation

Due to the complexity of confabulation, it can be challenging to diagnose. A psychologist or psychiatrist usually evaluates the person’s behavior and symptoms to determine if they are experiencing confabulation. The diagnosis can be confirmed through a battery of tests, including MRI scans or computerized tomography scans (CT scans) to identify any brain damage or dysfunction.

Treatment of Confabulation

Correcting confabulation is crucial, and the treatment is dependent on the root cause of the problem. In instances where the condition is temporary, such as following a traumatic brain injury or surgery, the person often improves spontaneously over time. However, when confabulation is a symptom of an underlying condition such as dementia, the treatment may involve addressing that condition. Psychotherapy and cognitive behavioral therapy can be helpful for some people in identifying and correcting confabulated memories.

How to respond to Confabulation

When someone is suffering from confabulation, it’s essential to respond in a patient and gentle manner. Being confrontational or dismissive of what the person says could make the situation worse, leading to further confusion and distress. Instead, it’s vital to listen to their version of events, validate their feelings, and calmly correct any false information. It’s also essential to involve healthcare providers to ensure that the person receives the correct treatment and care they need.

Confabulation in Popular Culture

Confabulation has been the focus of several notable stories in popular culture, including movies, TV shows, and books. Some of the most famous examples include:

  • Memento (2000)- a psychological thriller film that follows a man with severe anterograde amnesia, leading to confabulation.
  • Mr. Robot (2015)- a TV show where the lead character suffers from confabulation due to his schizophrenia
  • The Sinner (2017)- in which the lead character suffers from provoked confabulation, leading to a criminal act.


Confabulation is a complex and challenging condition that can significantly impact a person’s life. Differentiating between reality and fantasy can be difficult, so it’s essential not to be confrontational but instead to approach the situation with patience and understanding. With a proper diagnosis and a targeted treatment plan, it’s possible to correct confabulation and improve the person’s quality of life.

Common Questions about Confabulation

  • Is confabulation a sign of dementia?

    Confabulation can be a symptom of dementia, although it can also be a symptom of other conditions such as mood disorders or brain injuries.
  • Can confabulation be treated?

    Yes, with a proper diagnosis and targeted treatment, it is possible to both prevent and correct confabulation.
  • How do you respond to confabulation?

    It is vital to approach the situation with patience and understanding, avoiding being confrontational or dismissive, which can make the situation worse.
  • Can confabulation be permanent?

    In some cases, confabulation can be permanent, depending on the underlying condition causing it.
  • What is the difference between confabulation and lying?

    Confabulation usually happens unintentionally and is a result of a brain disorder, while lying is a deliberate attempt to deceive someone intentionally.


1. Kopelman, M. D. (2010). Varieties of false memory. Cognitive neuropsychology, 27(1), 1-20.

2. Moscovitch, M., & Winocur, G. (1995). Frontal lobes, memory, and aging. Annals of the New York Academy of Sciences, 769(1), 119-150.

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