Once, towards the end of my first year of college, I was talking to the Senior who had given me a tour of campus before I applied. He was asking me how I decided to major in Cognitive Science. In an effort to avoid the long silence of me reconsidering my whole life, I said the first thing that came to mind which was something along the lines of, “I just signed up for classes that sounded interesting, and I ended up liking Intro to Psych the most.”

To which he replied, “Interesting. I was also considering Cog Sci, but I didn’t like Intro to Psych that much.” Which shattered my brief illusion that I liked it. It was certainly one of the less interesting classes I took in college, but I had to take it to get to other Cog Sci classes I wanted to take. But at that point, it would sound too insane to say something like, “Oh yeah. I didn’t like it either.” so I just shrugged and forgot the rest of the conversation.

A similar thing has happened to me 2 or 3 other times. Someone asks me a questions, I respond with a reasonable sounding answer, and their reaction reveals to me that my initial reasoning was made-up and untrue. I specifically want to differentiate this experience from the similar one of leaving a movie thinking it was pretty good, and then someone else saying they hated it, and shifting to agree with them. That seems always seems to me to be more intentional. You know you’re lying to fit in. In this other case, confabulation, I don’t initially realizing I’m lying, and it would be weird to publicly switch to the position you agree with.

Anton Syndrome

Anton Syndrome is a rare stroke sympton characterized by blindness and the inability to admit to blindness. Patients with Anton Syndrome will confidently and incorrectly describe their surroundings and then run into things while trying to navigate them.
This confabulation is not unique to Anton Syndrome. As indicated by its more descriptive name, visual anosognosia, Anton Syndrome is the combination of blindness with the more general symptom of anosognosia, unawareness of their condition. It has also been noted in deafness and hemiparesis, also often following a stroke.

In the case of hemiparesis, anosognosia ranges from mild, where patients don’t spontaneously mention their hemiparesis, to more severe where patients sometimes cannot be convinced that they have any problem at all. These more severe patients may give various reasons for not moving their bad limb. They may say that leg is just tired, but they could move it if they wanted to. When asked to clap, they may refuse because they’re not at the theater. When asked repeatedly, they often get angry at the researcher.

When I first learned about confabulation in the clinical psychology context, it struck me as being a drastic distortion of normal reasoning. Take the example of a woman who refused to clap because, she reasoned, she was not at the theater (when in reality she couldn’t move one of her arms). At some level, she must have been aware of here hemiparesis. Otherwise, she would have tried to clap, and failing, realized she couldn’t move her arm.

Rather, she knew she wasn’t going to clap, (and she is blind to the true reason) so she searches in a bucket of “reasons no to clap” and lands on “I’m not at the theater”, a valid reason not to clap. That is, her one deficit is in not recognizing her immobility, but her independent reasoning facility is working as normal. This also explains why she might get angry as she kept being asked to clap. If she is observing that she’s not clapping (despite exhortations), then it must be the case that she’s at odds with the researcher. They’re asked her to do something that she doesn’t want to do.

Everyday Confabulation

Fortunately, in everyday life, our motivations are not so easily and objectively explained away by our recent strokes. Nevertheless (perhaps even moreso), we are asked to explain our feelings and motivations (e.g. “What do you like about her?”, “Why are you majoring in Cog Sci?”) whether to others or to ourselves through introspection. I doubt we are any more correct than the Anton Syndrome patient for we are not only blind to our own motivations, we believe we know them. And we’re all just stumbling around our rooms, shouting out our descriptions based on things we’ve bumped into in the past or things we hear other people shouting out from their own rooms. And just as we hallucinate our physical reality, we confabulate our internal reality.