Confabulation
Self Deception
Various forms of confabulation, including denial of illness (e.g., paralysis, blindness), and conditions that often give rise to these disorders, such as cerebral disconnection, disinhibitory states, incomplete information reception, and"gap filling" are discussed. On the basis of clinical observation and a review of a number of studies, it appears that confabulatory states frequently are associated with cerebral damage that involves the right hemisphere, notably, the frontal (often bilaterally) and parietal lobes—areas intimately involved in arousal, attention, information regulation, and integration. With certain forms of injury, initially there appear disturbances in the organization, integration, and assimilation of ideas and associations, such that large gaps appear in the information transmitted to and received by the language axis of the left hemisphere. It is argued that in these instances, the language areas act so as to fill these"gaps"with information that, although inappropriate, is linked in some manner to the fragments received. In contrast, frontal lobe damage sometimes results in gross disinhibition and cortical over responsiveness and, thus, speech release due to the flooding of the language axis (and other cortical regions) with tangential, fantastical, and grandiose associations. Other forms of confabulation also are reviewed briefly.
A less common yet more extreme form of"lying,"or deception, is confabulation. Unlike self-deception, in which the individual resists admitting his true store of knowledge, the confabulator often appears to be unable to recognize the erroneous nature or absurdity of his statements even in the face of painfully (seemingly) apparent contradictory evidence. Hence, his replies to questions or statements may appear tangential, circumlocutious, irrelevant, and delusional. Moreover, rather than relinquishing an incorrect belief when confronted with contradictory information, these individuals may make further erroneous extrapolations or partially incorporate some aspects of the contradictory information within the confabulatory schema.
Inevitably, in order for an individual to confabulate, erroneous information must become integrated in some fashion so that the confabulated response can be expressed. When the frontal lobes are compromised, there is much flooding of the association and assimilation areas with tangential and irrelevant stimuli and information, much of which is amplified erroneously completely out of proportion to more salient details, and a proportion of which appears due to the disinhibition of impulses and ideations that normally are filtered out (or at least denied linguistic expression). Consequently, salient and irrelevant, highly arousing and fanciful information is expressed indiscriminately.
Edited by hrc579, 09 December 2007 - 05:14 AM.