Who uses it: Psychiatrists, neurologists, and alcohol addiction therapists
What it means: In cases of short-term memory loss or momentary blackouts, the brain fills in missing information. As a result the alcoholic may not realize he or she has blacked out, and may not realize that the story he/she is telling is untrue, or missing pieces.
How you can use it: When you're making stuff up.
Years ago, I had a friend with a drinking problem -- in fact, to call it a drinking problem would be like calling Katrina a rainstorm. The wife of a mutual friend once talked to me about this person, and casually dropped the phrase "pathological liar." I understood what she meant, but she was wrong. Our friend might not even have realized they were lies. They were stories about things that happened under the influence, and largely confabulated.
Confabulation is the kindest explanation I can think of for the revelations about James Frey's "memoir," A Million Little Pieces. I'm not going to talk about specifics, because I haven't read the book; I picked it up, read the first few pages, and disliked the prose and the narrator so intensely I couldn't continue.
I'm not a fan of addiction memoirs, because here's the thing: addicts lie. Addiction happens for many reasons, some physiological, some psychological -- but addicts almost always turn to their substance of choice because real life is too painful. Lying is part of that, both cause and effect. Addicts lie for the same reasons they drink or use drugs, because they can't or don't want to deal with the realities of their lives. They also lie because they can't or don't want to remember what really happened.
So some of this righteous indignation about James Frey's "memoir" being fiction is naive, at best. As the old story goes, we knew he was a snake when we picked him up.