A 61-year-old man with a long history of heavy alcohol use is asked what he did yesterday. He answers immediately and confidently that he watched his grandson's football match and had lunch with his sister. His grandson does not play football, and his sister lives abroad and has not visited in over a year. He shows no hesitation and becomes mildly irritated when the discrepancy is gently pointed out, insisting his account is accurate. What is this?
This is confabulation: an unintentional filling of a memory gap with a false account the person genuinely believes. It is not lying, because there is no conscious intent to deceive — his confident, unhesitating delivery and irritation at being doubted point away from deliberate deception. It is not pseudologia fantastica, in which the person retains some awareness that the story is invented even while getting caught up in it. And it is not a simple memory lapse, because a lapse leaves a gap rather than actively producing new, if inaccurate, content the way this account does.
References
- Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 5, 'Disorders of Memory'.