Neurological Correlates

Confabulation and compulsive lying have a lot in common, and above is my Venn diagram of that overlap. (N= ? I just made it up).  Confabulators typically falsify memory by guessing or imagining an event, and then backfilling to assume it really happened. Compulsive liars, on the other hand, are aware they make stuff up, and compulsively lie — it’s like a tic or a compulsive motor activity, except this is a complicated cognitive function.  Yet, both involve the inability to choose among multiple cognitive functions combined with a compulsion to speak.

Here’s an example: A start-up founder railed against an ex employee for stealing all sorts of stuff and plotting to start up a competing business. I met with the founder, and saw that he had definite neurological soft spots. He was compulsively rambling on about this story and when I pointed out inconsistencies,  he did stop and consider them. But then he continued to selectively cherry pick facts, saying,  “Well, I didn’t say it was for sure, I only said it looks like it. . . “  There seemed to be a compulsion to speak , to construct a narrative supporting this hypothetical — to create a confabulation that became more and more definite as he spoke.

Here’s an explanation:

Zannino GD, Barban F, Caltagirone C, Carlesimo GA.,” Do confabulators really try to remember when they confabulate? A case report,”  Cogn Neuropsychol. 25: 831-52. Epub 2008 Sep 1. PMID 18780209

Since Korsakoff’s (1889/1955) first descriptions of confabulation at the end of the 19th century, all attempts to understand this neuropsychological disorder have focused on memory dysfunctions. Although the precise mechanisms underlying confabulation are still a matter of debate, the prevalent view is that confabulation is the output of a faulty recollective process. In the present paper we raise doubts about this undemonstrated assumption, arguing that confabulators are not necessarily attempting to recall when they confabulate. We describe a patient (M.L.) who floridly confabulated after a ruptured aneurism of the anterior communicating artery. The patient was administered a range of verbal tasks that required either memory recollection or other kinds of cognitive processes not involving memory. We conclude that the memory dysfunction exhibited by our patient represents one of many manifestations of a more general underlying disorder characterized by an inability to select the cognitive process that matches the task requirements in conjunction with a compulsion to provide verbal responses.