Confabulation and delusion: A review of Hirstein's Brain Fiction

Robyn Langdon*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    3 Citations (Scopus)


    Confabulation, according to Hirstein (2005), takes many forms of ill-grounded storytelling. It can be seen in clinical conditions, including amnesia and delusional syndromes, and in healthy adults who fabricate excuses and self-deceive. Hirstein suggests that confabulation, in all its diverse forms, is caused by a combination of two "errors": a knowledge error, which disrupts creative explanation-making, plus a checking error-a failure to detect and curb ungrounded fabrications. The second error, he suggests, is common to all confabulators. In clinical cases, it is caused by damage to the orbito-frontal cortex (OFC) and, in nonclinical cases, the OFC checking mechanisms are functionally misdirected away from the fabricated content. While I found much of interest in this first "big-ideas" book of its kind about confabulation, I doubt that any single checking mechanism, whether broken or derailed, will unify the diverse phenomena which Hirstein describes as confabulatory. I distinguish between the various symptoms of "confabulation" under discussion in Hirstein's book and pay particular attention to the relation between confabulation and delusion.

    Original languageEnglish
    Pages (from-to)785-802
    Number of pages18
    JournalPhilosophical Psychology
    Issue number6
    Publication statusPublished - Dec 2009


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