It wasn’t so much the lies that intrigued William Hirstein as it was the absolute certainty with which they were delivered.
Hirstein, an associate professor of philosophy at Elmhurst, was working on a postdoctoral fellowship in the late 1990s when he first began encountering people who created sometimes bizarre fictions about themselves and, chillingly, seemed to believe every false word. A stroke victim described in detail a just-completed weekend trip to a business conference hundreds of miles away—when in fact he had not set foot outside the hospital. Another hospital patient insisted that the people visiting him and claiming to be his parents were imposters. Still another, paralyzed on one side of her body, told doctors that both her arms were perfectly fine. Asked to use her paralyzed arm, she declined, explaining that arthritis was troubling her.
The fictions varied wildly from patient to patient, but they were invariably uttered with an unshakable certitude. “Something about their utter certainty was striking and disturbing,” the professor recalls. “It made me wonder what exactly had gone wrong with these people.”
The search for an adequate explanation is the subject of Hirstein’s book, Brain Fiction: Self-Deception and the Riddle of Confabulation, published in 2005 by MIT Press. The patients Hirstein met were confabulating—creating and uttering falsehoods even while believing they were telling the truth. Confabulation has puzzled psychologists and cognitive scientists for years, but Hirstein’s book is the first full-length treatment of the subject. It blends philosophy and neuroscience to lay the foundation for understanding confabulation and what it can tell us about human nature and the workings of the brain.
Confabulation is sometimes called “honest lying,” because confabulators seem to have no intention to deceive their audiences. Indeed, Hirstein says, they are often strangely oblivious to the implausibility of their stories and to the disbelief of their listeners. The problem, rather, is that confabulators are deceiving themselves. Hirstein writes that confabulation can be thought of as “a sort of pathological certainty about ill-grounded utterances.”
Researchers have cataloged a variety of syndromes and disorders that involve confabulation, and even a partial list serves as a disquieting primer in the ways the mind can misfire. They include Anton’s syndrome, in which blind patients claim to be able to see, and offer vivid—and utterly false—details about what they are looking at. In an even rarer disorder, Capgras’ syndrome, patients claim that loved ones have been replaced by imposters. Patients who suffer paralysis as the result of strokes sometimes deny being paralyzed, a condition called anosognosia. In other cases, labeled asomatognosia, patients will even deny ownership of their paralyzed limbs. Shown his own paralyzed left hand, a patient may tell his doctors with great conviction that the hand does not belong to him.
For all the strangeness of the symptoms he witnessed in clinics, what struck Hirstein was the way confabulatory patients reminded him of people he saw in everyday life. Even as his work took him deeper into the unsettling world of neurological disorder, he began seeing traces of confabulation in the ordinary actions of even perfectly healthy people.
“I began to notice confabulation in normal people. We all know people who seem too confident, or who are unable to express doubt,” he says. “We’ve all run into the salesman who seems to believe his own line of B.S. It may be that there is a basic need to lie to ourselves in certain situations, and in some ways, all the time.”
Hirstein writes in Brain Fiction: “It started to become apparent to me that what we were seeing in the patients was an extreme version of some basic feature of the human mind, having to do with the way we form beliefs and report them to others. If this is true, there should be much to learn from a study of confabulation, or at least that is what I argue here.”
The common link in all the confabulation syndromes, Hirstein says, is some kind of damage to the brain, often to the frontal lobe. He says that his book seeks to lay the groundwork for a unified theory of confabulation that would explain all the syndromes and yield insights into the way the brain functions and malfunctions.
The professor argues that confabulation is the result of a disrupted relationship between two processes in the brain: first, the creative process of forming plausible and satisfying answers or stories; and secondly, the editing or verifying process that monitors and controls what we say. Confabulators, Hirstein says, retain the ability to create stories, but brain damage has compromised the second function. “One of the characters in an inner dialogue has fallen silent, and the other rambles on unchecked,” he writes. Confabulators are left unable to recognize that their false answers are fantasy, not reality.
One of the most remarkable things about Brain Fiction is the way it unapologetically leaps across the boundaries between academic disciplines. Hirstein’s tools include not only the philosopher’s speculations about human nature but also data about the physical connections and disruptions found in the brain. Brain Fiction fits into a recent movement on the part of some philosophers to harness the wealth of new data about brain function generated by advances in medical technologies, and use it to fuel fresh thinking about such age-old problems as perception and consciousness. Sometimes called neurophilosophy, the movement has predictably attracted criticism both from other philosophers and from cognitive scientists. To some philosophers, neurophilosophy is guilty of cheerleading for science; some scientists accuse neurophilosophers of being dilettantes prone to wild speculation.
Hirstein replies that his approach is simple. “I construct hypotheses and try to knock them down, using data from any discipline,” he says.
He began his study of confabulation in conjunction with one of the luminaries of neuroscience, the psychologist V. S. Ramachandran, who supervised Hirstein’s postdoctoral fellowship. Beginning a sabbatical this fall, Hirstein plans to delve deeper into the mystery of confabulation, and he promises his approach will continue to carry him across disciplinary boundaries.
“I think members of each discipline suspect I am really a spy for the other,” he laughs. “And maybe there is a certain amount of truth in that. I sometimes feel that way.”