Confabulation or ‘exotic story telling’ is a common technique used by people with intellectual disability to gain respect and approval from others. The stories they tell are often a reflection of way the client wants to be seen, and are a means of increasing other people’s opinions of them. It is often the lack of really valuable stories that a person can tell about their lives and experiences that leads them to confabulate.
Remember that people who confabulate are not deliberately lying, but are trying to impress. Some suggestions for navigating ‘exotic tales’ include:
- Don’t deny, diminish or contest the client’s story – there is little point in refuting what is an absolute truth for the client at that point in time _ Don’t contest the client’s story: this sends the message that what the client has to say is not valued.
- The story may not in itself be real or valid, but the client’s reason for telling it is
- Remember that exotic stories could be true – do not disregard anything a client says
- Practise deep listening – try to hear the meaning behind the story the client is telling. What is the subtext? Are there any inconsistencies? What is the behaviour?
- If it is important to get to the truth for safety reasons, find a way to ask questions that are consistent with the fantasy; this will help the client to reveal what is really happening
- Confabulation decreases when there are good, real stories to tell – look for and value the real stories that the client can tell about themselves.