Posted 2006.11.28 11.22 in Family/Friends by Stephanie

What Is it?

Prosopagnosia (also known as face-blindness) is a condition where the individual is unable to recognize people by their facial features, and instead must rely on other visual or non-visual clues in order to determine who someone is. Prosopagnosia is not an eye problem, Prosopagnosics can see like anyone else.

For an analogy, both colour-blindness and tone-deafness are good examples. A person who is “colour-blind” is neither blind nor do they see in black-and-white. Rather, they do see colours, but they are unable to differentiate between some colours. I.e. green and red might look the same to them. Similarly, a person who is “tone-deaf” is neither deaf nor are they unable to hear music. They are merely unable to differentiate between two different tones. In this way, a person who is “face-blind” is neither blind nor unable to see faces; they are however unable to differentiate or use faces as a means of recognizing others.

Basically there is a portion in the human brain that is designed specifically to process facial recognition. This portion of the brain (called the “fusiform face area”, in the right temporal lobe), can normally recognize individual faces out of thousands and thousands ‘stored’ in people’s memory. It is thought this specialized ‘facial recognition area’ of the brain developed due to our social structure and the need to recognize, in an instant, if another person is friend, foe, or stranger. In normal people, friends and acquaintences are usually recognized automatically, subconsiously, in a fraction of a second. Prosopagnosics may take up to 10 seconds or more, to figure out who someone is – and by then, the someone may have already left.

Prosopagnosics are frequently also unable to recognize facial emotional expressions or misinterpret those clues, due to their inability to properly process facial features.





How Do You Get It?

It is a not-well-understood condition, but it seems it can be both inheirited, or acquired. Typically it is more easily diagnosed in those who have acquired it later in life as a result of brain injury or trauma, because a) they are already seeing doctors for the injury / trauma, and b) suddenly they can’t recognize anyone so they know something is wrong. Those who were born with it often don’t realize they have they have a known medical condition, because they have known no other way of seeing and recognizing faces. They only know they’re not very good at recognizing people, and usually chalk it up to bad memory or poor social skills.

Until the mid 1990’s there were only a hundred or so known cases of Prosopagnosia and those cases were almost entirely of patients who had acquired the disorder later in life. In fact at the time, scientists didn’t think that it could be inheirited. Since the mid 1990s, thanks to global communications and the rapid growth of the internet, more and more people have learned of the disorder and more and more people have come forth realizing that they are not alone in their inability to recognize others. Now, the vast majority of cases are inheirited Prosopagnosia rather than acquired. In addition, Prosopagnosia is now known to be much more common than originally thought.

An article in New Scientist (March 2005) states that a team of scientists in Germany have been able to prove that inheirited prosopagnosia does run in families. Inheirited prosopagnosia can sometimes (but not always) be found in conjunction with other conditions, such as Topographical Agnosia (not remembering places), Central Auditory Processing Disorder, and Aspergers Syndrome. Like many neurological disorders, prosopagnosia is not all-or-nothing — Prosopagnosics experience the disorder to varying degrees.





How Does It Affect People?

Lifelong Prosopagnosics tend to be somewhat independant and may be seen as ‘loners’, due to the stress and difficulty of making new friends. If you don’t think that’s stressful or difficult, think of how many friends you’d have if you couldn’t recognize them the day after you met them (or after having met them a half dozen times). People tend to be insulted, offended, or think you’re an idiot, if you fail to recognize them instantly. For normal folks, it’s an automatic thing. For a face-blind person, it’s a struggle.

It’s also been suggested that Prosopagnosics tend to make friends with people that have traits or characteristics that are easily recognizable to them. It’s a subconsious thing of course, but if you imagine say at school, out of 30 classmates, 28 of them appear to you as all very indistinct and you can’t tell them apart really, you’re more likely to gravitate to the 2 who do ‘stand out’ to you. And by the same token, if you were always getting the names wrong or not recognizing the others, those others are less likely to want to be friends, thinking you to be stupid or stuck-up or the sort.

Prosopagnosics often aren’t too interested in movies or tv, because they find it difficult following the plot, due to not being able to recognize the characters, from one scene to the next. Personally, years ago, I developed my own method of ‘watching’ movies and tv: I don’t watch, I just listen while I do something else. I found I could follow the plot just as well by listening (I am pretty good at telling voices apart). If I have to sit and watch tv I just get kind of bored because the visual stuff is kind of pointless and confusing. Of course there are exceptions. Sci-Fi shows tend to have characters that are easily identifiable, due to make-up or other distinctions. Animated characters seem to be easier to identify as the characters are more like drawings than people (duh!). And some shows simply have a diverse-enough cast that makes it possible to differentiate the main characters, without too much difficulty.

Finaly, Prosopagnosics can sometimes be less social than ‘normal’ folk, or rather, socialize in different ways, so as to lessen the number of stressful situations they end up in. For instance, they may not enjoy team sports, due to the fact that in-uniform, everyone in their team looks the same to them while away from the game (out of context of the sport) they may not recognize team members at all. For me, conventions or other large gatherings are terribly stressful because everything is out of context. I simply won’t attend unless there’s someone with me, so I can rely on them to recognize people and follow their lead. And even at that, it’s a very stressful experience: “Oh, look who it is!” they exclaim. And I look at the hundred or so strangers in my field of view and reply “Uh, yeah. How bout that.” and wait till my collegue goes and shakes someones hand or the sort, before I even know who I’m supposed to look at. Then I study to try and figure out who they actually are.





What’s It Like?

Here are a couple examples from my own experience. These are indicative of the countless similar situations that happen to me on a daily basis.

  • I once spent 2 or 3 minutes in conversation with a ‘stranger’ who’d simply approached me on the street. I thought he was just very friendly so I politely talked with him. After a couple minutes I figured the polite thing to do was ask his name. He responded with a shocked, perhaps offended look, before telling me. The ‘stranger’ whom I had ‘never met before’ was a long time family friend whom I had met many times before. He was also our town’s mayor and even if I didn’t know him personally I had seen him in the paper or on the tv many times too. This is not to say that I had forgotten him or who he was. Nothing of the sort. I simply could not recognize him by looking at his face.
  • A friend was showing me photographs he had taken at an event only a week previously. I pointed to one of the pictures and asked who the hell that was, not recognizing the woman at all, not remembering her at the event. My friend looked at me sort of lost, not knowing what to say. Actually in retrospect, he looked at me as if I had some kind of neurological disorder 😉 After a few more seconds I realized that the stranger I was pointing at, was me! I still don’t recognize my face in pictures but I have learned other ways to recognize me so I don’t make that blunder again.
  • Through work, once a month I have to drop off a box of documents with one of our suppliers. I see her every month, and frequently we chat face to face for 10 or 15 minutes. And every month when I go to her office, I have no idea what she looks like so I just kind of smile and wave at everyone till I find the one who responds by reaching for the box I’m carrying. Then I know it’s her and we talk etc. This is particularily upsetting for me because I see her every month in the same context and have done so for about 18 months now but I still don’t ‘know’ what she looks like.
  • I once attended a get-together, met someone interesting, and spent the evening talking with her about all kinds of stuff. After the get-together was over, we ended up talking another hour or so while standing outside next to our cars. Probably spent about 6 or 7 hours with her in total, at the get-together then afterwards. It wasn’t till years later that I was talking with ‘someone else’ about something else and she mentioned in passing, that she remembered what a good conversation that was that we’d had, lasting so long out in the parking lot. I was stunned to realize it was her, stunned that I didn’t remember it had been her, but of course I’d learned long ago, never to let on about such ‘blunders’.

I could go on with many other similar stories, but they’re similar so it’s not really necessary. The point is, I do not recognize people by their faces. I look at hair, at height, at outline (body shape), at clothes, at movement, and listen to voices. And the biggest thing for me is context. I meet work people at work environments, family at family settings, and friends at the places we congregate. If someone turns up out of context, like a business acquaintence at the mall, I will almost certainly not recognize them, and simply walk on past as if they were a stranger. Unless they call out or the sort, then depending on how well I know them, I might recognize them, or I might have a brief friendly conversation then walk away wondering who they were.

Fortunately my Prosopagnosia is not extreem – I can recognize my immediate family and close friends most of the time. Despite this, if I had arranged to meet, say, my parents at a restaurant or mall or something, until I actually find them I have always had a lot of anxiety that I’d be unable to spot them. And when looking for them, or anyone, I tend to really have to study everybody to find the ones I’m looking for. Until I knew about Prosopagnosia, I was very troubled by the fact that I couldn’t actually remember what my immediate family or closest friends look like – I mean, I can’t close my eyes and visualize their faces. Now I know why.

(If anyone reading these examples has realized I’m talking about an encounter with them, please don’t be upset or offended – It’s nothing to do with you personally! I can’t help it, it’s a neurological thing!)





A Photograph

Who are you?
This photo sort of illustrates what I get when I try to visualize people in my mind. I mean, I know people have eyes, a nose, a mouth. When trying to remember people though, I just draw a fuzzy blank when it comes to the face.

In this example, the photo is of me, and I recognize it as me because of the hair, the overall shape/outline, and the clothes and jewelery. It doesn’t even strike me as terribly odd to see myself without a face. Half the time when I look in the mirror, I ignore my face because that’s about how often I even recognize the person in the mirror. Whether myself or my family or my friends, the result is the same when trying to picture them in my mind. I get lots of other clues – height, hair, shape, size, but no face.

Let me emphasize, this is not how I see people, this is how I remember people. And this is why it is difficult for me to recognize folks. I’m also going to mention here that, prior to knowing about Prosopagnosia, I never would have admitted this to anyone. Think about it. How do you tell your parents, your sister, your closest friends, that you can’t remember what they look like? I was terribly ashamed and embarassed about this – what an awful person I was, to not remember the faces of those closest to me.

So, study the photo. Now, would you recognize me if we passed each other on the street? In a mall? If I dropped by where you work? What if I change my hairstyle, or wear a different outfit?





What’s the Cure? How do you cope?

At the moment there isn’t even talk of a cure on the horizon. There simply isn’t enough research and understanding yet. Scientists do not know exactly what mechanism causes Prosopagnosia, how it develops, what part of the brain is affected, et cetera. They are still in the process of learning and trying to understand the condition. Indeed, many if not most doctors, psychiatrists, and psychologists, don’t even know what Prosopagnosia is.

As for how I, personally, cope with it… having had the condition all my life I will go on dealing with it exactly as I have done all along. I’ll continue to struggle to identify people. I’ll continue to not recognize people when passing them in the street or at a mall. I’ll continue to be stressed about recognizing them when trying to find them. And I’ll continue to rely on non-facial methods for recognition.

In fact, having only just learned about Prosopagnosia, only just realized that I have a neurological disorder, there is one way I see my life improving! I used to feel ashamed, angry with myself, for not recognizing friends and family, not being able to remember what they look like. Now, I don’t have to feel that shame, that self-anger. Indeed, now that I know what is happening (or not happening as the case may be) I can consciously focus on the non-facial attributes and hopefully get a little bit better at recognizing folk.

For lifelong sufferers of Prosopagnosia, there really aren’t any new ‘tricks’ or anything that can be learned, however. We’ve all developed our own methods and strategies over the years and aside from consciously trying to hone those methods, there’s not much we can do. “Trying harder” or “focusing more” won’t help, it might even worsen things with the added stress and added emphasis on the face, that we can’t ‘get’ anyways.

For those unforunate enough to have acquired Prosopagnosia later in life, there are things they can learn. The non-facial methods have to be learned and I am sure it is a difficult process for them. By learning those cues though (hair, height, body shape, age, voice, movement, etc) they can learn to start recognizing people again.





More Information – Links

Q. How many surrealists does it take to change a lightbulb?

Posted 2006.11.28 1.00 in Pointless Blather by Stephanie

A. Two. One to hold the giraffe and the other to fill the bathtub with brightly coloured machine tools.

Found in the sig area of an email by Thomas Stephenson. Thanks Thomas!