The Road Not Taken: Finding America in the Poem Everyone Loves and Almost Everyone Gets Wrong by David Orr:
We also, one might say, create a deception. But this seems a little harsh. Better, maybe, to say that we create a narrative that works for us, and that we can live with. It’s interesting, in light of this, to think about the phenomenon scientists call confabulation. Confabulation isn’t lying, as you might suppose, but rather the invention of explanations or stories on the basis of information that is incomplete, incorrect, or manipulated (as in an experiment, for instance). A person who is confabulating may be saying something thoroughly ridiculous, but he doesn’t actually know that it’s absurd. He’s simply expressing the best available conception of the world as it seems to him, and he believes in that conception unswervingly. “Confabulation,” writes the philosopher William Hirstein, “ . . . .is a sort of pathological certainty about ill-grounded thoughts and utterances.”
Of course, certainty about “the world as it seems to him or her” will seem especially strange if the person in question has suffered some kind of neurological damage. This is why many of the best-known studies of confabulation involve a parade of unfortunate medical conditions like Korsakoff’s syndrome (sufferers have lost short-term autobiographical memory), anosognosia (in which a paralyzed person appears unaware of his condition), asomatognosia (the sufferer denies ownership of his own body parts), and the legendarily bizarre Capgras syndrome (in which a person believes friends and loved ones have been replaced with physically identical impostors). In each of these cases the patient will, with perfect confidence, provide explanations for various occurrences that are, on their face, impossible—for instance, a person suffering from Korsakoff’s might, if asked what he did yesterday, answer by reciting events that occurred to him twenty years ago.