Commentary on “The Pleasantness of False Beliefs”

“Will you, won't you, will you, won't you, will you join the dance?”

The question

Brain damage may drive mental life either outward or inward, to join or not to join the Dance. In the latter case, it may unveil an underlying level of mental function that previously was covert. With that possibility in mind for the genesis of confabulations, Turnbull, Jenkins, and Rowley present an innovative study of the emotional valence of confabulations uttered by three patients with ventromesial frontal injury. They nest their empirical presentation in a more extensive discussion of method and theory.

Confabulation has been defined as “spontaneous narrative reports of events that never happened” (Schacter, Norman, & Koutstaal, 1998). This definition has to be qualified by the fact that the event may be in the present or future, as well as in the past (for a recent and comprehensive review, see Schnider, 2003). Whether the patients really believe what they are saying or are instead speaking metaphorically is hard to ascertain, and not part of the definition. However, the patients are not merely misinformed, and conscious attempts to deceive are also excluded from the construct.

Confabulation is associated with organic amnesia, prefrontal deficits, or both in conjunction (DeLuca, 2000). In some cases, it reflects flawed emergence of language at the level of which concepts are specified in that domain (Brown, 1988). In others, there is flawed emergence of meaning. Confabulatory speech has been attributed to failure of the brain to monitor the emerging proposition for accuracy (Johnson, 1997). These and others models of confabulation do not take into consideration the expected valence of confabulatory utterances. Turnbull and coauthors conceive the issue from a psychoanalytic perspective, as lapsed editing of primary-process contents by secondary processes, before they are expressed in words (Solms, 2000).