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Neural Cartography and Confabulation

 

 

By Zachary P. Norwood

 

 

 

A Review of Brain Fiction: Self-Deception and the Riddle of Confabulation by William Hirstein; MIT Press, 2005.

 

The true nature of the present revealed itself: it was what existed, and all that was not present did not exist. The past did not exist. Not at all. Not in things, not even in my thoughts. . . . Now I knew: things are entirely what they appear to be — and behind them ... there is nothing.

— Roquentin, from Sartre’s Nausea

 

 

 

Unless you’re like the protagonist in Sartre’s Nausea, who marvels at the sight of a chestnut tree, transfixed by its raw existence, you probably find everyday sense impressions rather boring, as you should. After all, who would think to marvel at the sight of a common tree, or the simple recognition of someone’s face? And even if we could, would we want to? I think not. If we were mindful of every little thing the brain filters out of consciousness—if the wiring of neurons had a sensation—we would certainly go mad. There’s a reason we evolved with built‑in perception filters. Without selective attention and recall, without a narrowing of conscious perception, we would be overwhelmed by meaningless sensory information—every passing tree would metamorphize into terrifying arrays of reflected light.
 

Although the brain’s natural filtering process is a blessing, there are a few special cases when it can produce undesirable consequences, one of which has to do with memory.
 

Remembrances of things past are formed by mental representations, memory traces left behind by sense impressions. Thus, depending on certain modulating factors, such as the time and duration of exposure, the type of stimuli, and so forth, the veracity of our representations may fluctuate. If you are startled by a bear in the woods, for example, certain variations of stimuli will alter the outcome of remembrance: if you are alone and the bear is a grisly, your brain will soak up every nuance of the encounter, calculating unconsciously all the possible reactive possibilities, but if you are with a group and spot a small black bear at a distance, you will likely look on with anxious, excited curiosity. The bear in the woods is an example of external differences that may alter representation, but there are several internal influences as well: personality differences, such as introversion and extraversion; mood differences, like dysthymia and euthymia; and acquired or genetically predisposed neurological differences, such as brain damage, schizophrenia, and Alzheimer’s disease, are all examples of modulating factors that may impinge on the verity of remembrance.
 

With all this in mind, I looked forward to reading William Hirstein’s new book, Brain Fiction. Its primary subject, after all, deals with a rare clinical condition termed confabulation, which can be loosely defined as unintentional, severe misrepresentation of past or present beliefs, combined with both an apparent lack of awareness of the misrepresentation and an unwillingness to accept its potential falsity. There are a number of different instances of this condition, such as provoked versus spontaneous confabulation, which simply means confabulating in response to a question (provoked) or not (spontaneous), but on the whole, Hirstein focuses on the provoked variety, which is more common and less severe.
 

The bulk of Hirstein’s book is more or less a review of neuroscientific research directly or peripherally related to provoked confabulation, all of which leads to a speculative, tentative dénouement: an attempted operational definition of confabulation, grandly illustrated with the p’s and r’s of informal logic, which fleck the pages like an unfinished Jackson Pollack. While apparently necessary for Hirstein’s grand finale, the exhaustive review of neural anatomy conjures up images of a blind Sherlock Holmes trying to figure out how a Rube Goldberg machine works, though not by direct tactile sensation, but rather by reading descriptions of its inner workings in Braille. Chapters fly by, and you realize you’ve only learned that X brain area correlates with Y symptom, which may or may not elucidate the nature of confabulation. Hirstein’s seemingly never-ending review becomes all the more tiresome if you’ve already been introduced to the brain and its various functions, such as through the popular works of Damasio or Pinker—given the audience of Hirstein’s book, this will likely be the case.
 

Returning to the topic of confabulation, Hirstein outlines two primary components found in all cases of provoked confabulation. The first deals with the executive, “self-monitoring” function of the prefrontal cortex, and the second with disruption of neural anatomy subsuming memory functions, or as Hirstein likes to call them, equivocally, “knowledge domains.” When these two systems are conjointly damaged, confabulation occurs, yet when independently damaged, only various symptoms of confabulation are observed, and not the full blown, clinical syndrome.
 

In relation to the executive, prefrontal system, Hirstein raises several valuable insights, such as the innate interdependence of emotion and memory (or “epistemic” content, as he calls it). “In the view I propose,” writes Hirstein, rather confusedly, “confabulating is a behavior that results from disinhibition just as much as the behavior of disinhibited patients who make socially inappropriate remarks” (102). In other words, if one’s emotional centers are disengaged from mental representation of past or present beliefs, they will fail to receive any inhibitory feedback when misrepresenting those beliefs, and consequently they will fail to “self-monitor” their perceptions. Anyone who has come across the case of Phineas Gage—that is, most second-year college students, or everyone who gets past Chapter 4—will immediately think “prefrontal cortex” when reading Hirstein’s discussion of disinhibition, and low and behold, he makes the predictable connection: executive processing appears dependent on a small region in the frontal lobe called the orbital frontal cortex (OFC). The OFC is also connected with areas in the midbrain, such as the amygdal and hippocampal areas, that seem to modulate memory formation and distribution, which is why, according to Hirstein, certain symptoms of confabulation may be observed when these areas are damaged independently. Given the bidirectional projections from the OFC, amygdala, and hippocampus, it makes sense to implicate all of these as potential candidates for producing confabulatory symptoms.

 

Beyond the elaborate, neuroanatomical details of the emotion‑memory interface, I believe Hirstein misses several opportunities to explore the nuances of everyday problems associated with representation, such as how the mind unconsciously evaluates stimuli held in short-term memory using what Damasio calls “primary emotions,” which are directly related to Hirstein’s discussions of disinhibition. Unfortunately, Hirstein only mentions Damasio and related scholars, such as Rolls, in passing, as if he were overeager to move on to his own choice of descriptive terminology.


In one section, however, Hirstein delivers on his promise to elaborate on the non-clinical components of confabulation. He suggests in the conclusion of Chapter 4, again all too briefly, that there is a psychological continuum ranging from sociopathy, on the one hand, to obsessive-compulsive disorder (OCD), on the other. Corresponding to the sociopathic end of the spectrum is confabulation, with its gross misconceptions of reality, while at the opposite end we have a type of hyperawareness of representation, similar to that of OCD. Envisioning such a continuum helps us understand the relationship between disposition and perception. As an example, we could think of the protagonist in Sartre’s novel, with his hyperconscious perceptions of the outer world, as situating somewhere on the OCD end of the spectrum; conversely, we could think of our enthusiastic neighbor, who has a penchant for telling sensationalized stories, as situated somewhere on the confabulatory end. Unfortunately, Hirstein does not venture past his original sketch of the sociopathy–OCD spectrum, and we are once again thrown back into labyrinthine descriptions of neurological Rube Goldberg machines.

Based on the full title of Hirstein’s book—Brain Fiction: Self-Deception and the Riddle of Confabulation—along with the synopsis on the dust jacket, which tells us that “normal people, too, sometimes have a tendency to confabulate,” I justifiably assumed Hirstein would go beyond clinical cases of confabulation and deal with everyday examples of misrepresentation, such as false memories and benign misrecollection. An example of this would be the tendency of some individuals to embellish certain features of an experience, such as a fisherman (or our next-door neighbor) who swears he caught a 10-pounder when, in reality, the fish only weighed 5 pounds. Sadly, Brain Fiction only mentions the non-clinical features of misrepresentation in passing, simply as a means of enticing the reader to hold out for learning something relevant to everyday experience, which never seems to materialize.

There are several problems with this book, some organizational and others conceptual. The latter are partially due to the inherent limitations of our knowledge regarding the subject matter. We simply do not know enough about confabulation to avoid speculative interpretations of observed phenomena, of which Hirstein has no short supply. In terms of organization, however, there were many occasions when it seemed as if I were reading a first draft of someone’s doctoral dissertation, or a collection of fragmentary asides hastily strung together without regard to transition or continuity. This was especially apparent during later chapters, but the problem of excessive and fragmentary subsectioning was present throughout. I believe Hirstein or his editors could have done his readership a service by cutting out or unifying all the dead wood.

One of the most apparent and frustrating conceptual problems was the overabundance of terms used to describe confabulatory symptoms: vis., “mind-reading” and “modeling” deficits, “epistemic failures,” “representation” degradation, “memory” distortion, etc. Such overabundance of terminology would not pose a problem if Hirstein did not treat each term as if it were its own, independent construct, but he does—“epistemic failures,” for instance, are mysteriously differentiated from memory deficits, and “mind-reading” is somehow only peripherally related to representation. How one can talk of “epistemic failures” without addressing the inherent relationship between knowledge and memory is beyond comprehension, but I suspect this is another instance of Hirstein’s attempt to (understandably), make a name for himself by interjecting his original analysis.

Despite my frustrations with the problems of Hirstein’s book, I admire his undertaking: confabulation, by virtue of its intricate neurological underpinnings, is an exceedingly difficult subject to cover, and in this regard, Hirstein covers considerable ground. When science finally catches up to our speculations, I think Hirstein will provide us with another installment on the nature of confabulation, an event I will certainly look forward to. Only next time, I hope he skips the preliminaries and cuts to the chase, offering up more utility and less verbosity.

Notes:

 

Provoked versus Spontaneous Confabulation

Provoked simply means prompted by a question whereas unprovoked or spontaneous confabulation is not.

 

One of the most significant, recurring themes of modern philosophy deals with the seemingly inherent, universal limitations of conscious perception.

 

p. 235

 Eric Halgren's EEG research shows that the limbic system processes stimuli before "cognitive evaluation" of that stimuli, suggesting that unconscious affective processes may "distort or eliminate the conscious experience of an emotionally significant event."

 

p. 237

 "realizing the truth can be depressing. Certain forms of anxiety attack may occur when the self-deceptive processes break down and consciousness is flooded with the truth of things. ... perhaps with the advent of broad intelligence and foresight comes the need for confabulation and self-deception to keep depression and its consequent lethargy at bay."

 

p. 240

 "Why are we drawn to the confident, confabulatory person, while the doubt-filled person is always a bit unpleasant to be with? ... Partly because of the natural emotion-sharing processes among humans, the uninsured are person makes us uneasy. Whatever the reason, epistemic overconfidence can be a successful strategy in social interactions"

 

 
p. 241

Daniel Dennett may explain confabulation as a byproduct of narrative construction, or "the human need and tendency to tell a coherent 'story' about ourselves.

 

 

 

 

Zachary P. Norwood graduated from the University of New Mexico with degrees in research Psychology and English literature. Come this fall, he is pursuing his PhD in literary studies, most likely at the University of Auckland, New Zealand. His dissertation will explore the relationship between affective neuroscience and literary semantics.

 

 

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