1.Introduction
There has been some recent and growing interest in the continuity and discontinuity of cognition between clinical and non-clinical populations. Whilst some researchers have addressed these topics to call into question some normative standards of rationality typically used in the literature (Hertwig and Volz 2013), others have referred to the alleged presence of imperfect cognitions in both mentally ill and healthy subjects to argue that no effective demarcation between normal and abnormal cognition can be achieved and to combat the stigma associated with mental health (Sullivan Bissett et al. 2016).
Research on confabulation is of particular interest in this context. Confabulation is a symptom central to many psychiatric diagnoses which has more recently been reported also in non-clinical contexts. More precisely, it was originally discussed in the context of patients with Korsakoff syndrome with severe amnesia, who would report as memories events that either did not happen or had happened much earlier in the patient’s life (Hirstein 2005), but has also been associated with chronic alcohol consumption, posterior circulation stroke, traumatic brain injury, tutors, and schizophrenia (Schnider 2008, 75). Some non-clinical populations, such as highly hypnotizable subjects, have been described as particularly prone to confabulation (Cox et al. 2009). But confabulatory phenomena have been taken to be more generally a trait shared both by clinical and non-clinical populations (Coltheart 2017; Wheatley 2009). Notably, psychologist Fiery Cushman (2011) argued that the concept of confabulation that is typically used in the context of neurological patients and clinical populations should also be used in non-clinical contexts and to refer to the explanations of our own behavior that we typically provide, which are sometimes wholly fabricated, and certainly never complete.
Non-clinical confabulation has become a topic of special interest in several corners of scholarly research. For instance, philosophers have also started to write quite extensively on the topic (Sullivan-Bissett 2015; Balsvik 2017; Carruthers 2012; Mihailov 2016; Sandis 2015; Strijbos and De Bruin 2015; Scaife 2014; Roche 2013). As it turns out, there seems to be a commitment to the continuity of confabulatory phenomena in clinical and non-clinical populations. On the one hand, some scholars stress that clinical confabulation is more severe and involves a lesser degree of truthfulness (Mihailov 2016), and that it can be more debilitating to those who exhibit the symptom, “leading to estrangement from family and friends” (Wheatley 2009, 21). Importantly, however, references to confabulation in non-clinical contexts do not seem to be meant in a metaphorical fashion, but the phenomena are rather meant to mirror cases of clinical confabulation.
Here, it might be useful to distinguish between different conceptualizations of continuity. First, an epistemic version of the continuity thesis would state that there is no categorical difference between the epistemic features of cognitions and thoughts in clinical and non-clinical populations. For instance, one could claim that even if non-clinical self-deception and clinical delusions represented two different kinds of psychological phenomena, these could both involve the formation of inaccurate beliefs that are resistant to counterevidence, where such shared epistemic features would then grant some continuity between normal and abnormal cognition. Second, a psychological version of the continuity thesis would state that there is no categorical difference between the kinds of cognitions and thoughts in clinical and non-clinical populations, as the same psychological phenomena occur in both contexts. One could argue, for instance, that non-clinical self-deception and clinical delusions are not in fact two different kinds of psychological phenomena, in spite of some shared epistemic features. Notably, scholars interested in non-clinical confabulation seem to interpret continuity in the latter way, pointing to either shared mechanisms or cognitive functions. For instance, Max Coltheart wrote that confabulation should be seen as “a consequence of a general property of human cognition” (2016, 62), rather than a feature of abnormal cognition.