Delusion and confabulation: Mistakes of perceiving, remembering and believing

Abstract

This paper adopts an inclusive approach to the relationship between delusion and confabulation, according to which some symptoms might qualify as both delusional and confabulatory. Our initial focus is on the cardinal signs of delusions: incomprehensibility, incorrigibility, and subjective conviction. Setting aside post hoc (or secondary) confabulations—plausible rationalisations that might be generated by nonpathological belief formation processes—we focus on spontaneous memory-based confabulations which, we suggest, conform to the characterisation of delusions. After considering current accounts of the role of experience in delusion formation, we propose that spontaneous confabulations are located at (or towards) the “received” end of a “received-reflective” spectrum of delusions: the spontaneous confabulator simply receives and endorses as genuine the content of an apparent—yet implausible—memory experience. Underlying both spontaneous confabulations and other received delusions, we propose, is an inability to inhibit the prepotent tendency to upload and maintain experiential content (mnemonic or perceptual) into belief.

Keywords:

• Belief formation
• Confabulation
• Delusion
• Memory pathology
• Perceptual aberration
• Psychosis