Response to Commentaries on “Confabulation in Dementia: Constantly Compensating Memory Systems”

In “Confabulation in Dementia,” the approach was a combination of theories of discourse, cognition, and consciousness. The phenomenon of confabulation was explained as a dysdeictic retrieval process, which compensates for poor access to episodic memory and serves to preserve a premorbid self-image. The content of confabulations possibly is affected by unconscious motivation. Most controversial in the paper, I suspect, was the idea that confabulate utterances consist of preserved fragments of semantic knowledge retrieved in a cognitive system that is unconstrained due to poor executive functioning.

I am grateful for the interesting and sometimes critical responses and, having considered all initiated comments, will now try to bring my ideas a bit further. The commentaries on the paper strengthen my opinion that the use of a broad interdisciplinary approach is fruitful when it comes to such a complex phenomenon as confabulation. I think it is necessary to call attention to the scientific disciplines devoted to language and interaction, mainly linguistics, semantics, and sociolinguistics. After all, confabulation usually occurs as utterances that are aberrant and are created in interaction. Linguistics concerns the study of how human languages are structured, acquired, and used, and the linguistic sciences provide tools for analysis of language production and interaction. Semantics, and especially the semantic-pragmatic section, concerns meaning and how meaning is created in context, a very relevant topic in confabulation (see, e.g., Caplan, 1992; Lakoff, 1987; Levinson, 1983). One major advantage with the linguistic methods is that they enable analysis of utterances as products and that this can be done without considering the cognitive level of subjects. Linguistic studies of interaction in dementia and aphasia have contributed to the knowledge of irrelevant speech (see, e.g., Anward, 2003; Hamilton, 1994; Shakespeare, 1998).

Mark Blechner provided comments from a psyc