Unmasking Faceblindness

[ Note : A few years ago , I was watching a medical documentary at CNN. A doctor was showing pictures of famous people to a man ( an American ). The man was asked to identify the people in the pictures. When the man was shown a picture of Elvis Presley , he said “ That’s Brooke Shields.” That hit me ! How can somebody mistake Elvis Presley  for Brooke Shields ? The two artists were shown in their typical Hollywood appearance : Elvis , white  male with short  very dark hair   and Brooke, white female with long blonde hair. He can’t tell a man from a woman ? That moment spurred in me an interest in PROSOPAGNOSIA , the ailment that plagued that man in the documentary. I’ve been reading  and researching about it for some time  .The essay below is a  condensed  result. Let me caution you . I AM NOT A DOCTOR . I AM NOT AN EXPERT ON THE TOPIC. But my research has afforded me SOME KNOWLEDGE about it. ]

Unmasking  Faceblindness

               What if you woke up one morning  , found yourself in a strange  place,   surrounded by strange  people?  Then they  start calling you “ Honey ” or “ Dad “ or “ Uncle John ”.  In sheer confusion  , you retreat to the bathroom . Then , you look at the mirror  and to  your horror , you can not recognize  the person in the reflection.

           The above scenario may strike you as a Hollywood  thriller  , but about two percent  of the general population  ,  or about  six to eight million  people in the USA  alone (Sacks, 2010), experience these bizarre things on a daily basis .  They are  afflicted with a disease called prosopagnosia, or  faceblindness  , a neurological condition in which a person’s ability to recognize faces is impaired . It has  nothing to do with poor  eyesight or memory loss.

           Cases of  the impairment have been recorded as  early as the 19^th century .  However , it was only in 1947 when the term “prosopagnosia” was coined by a German neurologist  named Joachim Bodamer . He compounded the  Greek words "prosopon" which means "face"  and "agnosia"  which means "not knowing".  To many people , however ,  the word  “prosopagnosia ” is a linguistic abnormality that is impossible to pronounce and spell.  Due to the suggestion of some prosopagnosics  themselves ,  the words “ face blind ” and “face blindness”  became  readily accepted as layman’s  term.

           Prosopagnosics  exhibit different levels and types of impairment .  Most of them can not recognize the faces of  people they know  , including those  who are  close to  or intimate with  them . When a prosopagnosic looks at a  familiar person’s  face , say  a daughter or  the wife  , he can see the eyebrows , the eyes  , the nose , the lips , the cheeks , the chin --- but somewhere in the  depths  of his  mind –he can not figure out who that person is. The daughter’s face or the wife’s face is just as unfamiliar to him as a stranger’s face.

Some can not recognize themselves in recent photographs  and in  mirrors . A faceblind woman admits  making extreme facial expressions in order to recognize herself in the mirror of a public restroom .   Others reported having consistent difficulties in finding their way in familiar places. Perhaps , the most complicated of all , is not  being  able to tell the difference between a face and an object.  This particular symptom became the basis for the title of  Dr. Oliver Sacks’s book on faceblindness: “ The Man Who Mistook His Wife For A Hat”.

               It is important to mention at this point  that Dr. Oliver Sacks himself is faceblind . He is a well-known neurologist in the USA   and  a respected professor at NYU School of Medicine. He is the   author of  twelve books , which include “ Awakenings ” , a novel that was as made into a film starring Robin Williams and Robert De Niro .

         Prosopagnosics may also  be unable to  perceive gender  and  age difference , no matter how great the age  gap may be. One patient  was shown a picture of Elvis Presley and was asked to name him. The reply was  “ Brooke Shields ”.  (Song ,2006 ) Another prosopagnosic  reported   having a very difficult time   identifying  her daughter in a hospital room where there  was another patient .  Her daughter was 19 years old. The other one   was a very old woman , almost 100 years old.  And she could not tell which one her daughter  was.

                  There are two main  types of prosopagnosia . Developmental prosopagnosia  starts  from infancy or childhood. Studies from Germany in 2005  show that the disease may have genetic causes. People  with developmental prosopagnosia usually   grow into adulthood  without realizing that they have the illness. They grow up thinking that forgetting faces is normal  and that other people experience the same thing . But because awkward things happen to them  and not to other people , they come to  suspect that something is wrong  with them but consistently  fail to figure out , until the years plod on  , what exactly the problem is.   

The other type is acquired prosopagnosia which is caused by injury to the brain , stroke and neuro-degenerative  diseases. The specific area of the brain that is said to be affected  in prosopagnosia is  the fusiform gyrus^.  People who acquire the disorder later in life experience greater frustration and sense of loss because they know how it is to be normal . They know the feeling, the joy ,  of being able to recognize a loved one’s face. Suddenly being deprived of that joy throws them into deeper depression.

How the disease impacts the lives of people

         For  prosopagnosics , almost every social interaction is a torture . Every  simple misplaced greeting,  gesture ,introduction or  in many cases , non-reaction ,   usually has unpleasant  and awkward consequences . Bill Choisser,  author of the online autobiographical  book “ Face Blind !”( Choisser , 1997 )  reported having a serious conflict  with his mother after  failing to recognize  her as they walked past each other  on an almost empty street. Countless embarrassing  incidents  are likely to happen :   introducing the wrong person  as your  husband or wife , or  ignoring  your boss  while he is inches away from  you in the elevator . Other incidents may have serious legal consequences : picking up the wrong kid from school, failing to identify an assailant , or squeezing a saleslady’s breast because  you thought  it’s a scarf or a fashion accessory.

The impairment  severely limits a person’s career choices. Prosopagnosics can not be effective waiters or sales staff.  It is disastrous to give the wrong food to the wrong people , or to give a pair of  pink stilettos to a hefty  hunk who is actually looking for steel-toed boots. However , faceblind people can effectively   work in situations  where they interact with a small number of people :  that is , THE SAME PEOPLE   in  THE SAME PLACE  every day. For example , they can be trained  to be good at computer-related jobs . With little  assistance  from   colleagues , they can also excel in  media-  and arts -related careers like being a disc jockey , a radio announcer or a researcher. Again, it must be noted that Dr. Sacks was able to build a  successful career in medicine despite his impairment.

           Faceblind people also find it hard to make , keep and maintain friendship. New friends  and acquaintances   normally feel slighted  when they are ignored by someone . Unfortunately , a face blind person will,  most of the time,  ignore  people  because he can’t recognize them.

Even  recreational activities are adversely affected  by the impairment . Many prosopagnosics   can’t participate in friendly conversations because they are not sure who they are responding to.  They don’t enjoy movies   because they can’t differentiate between major and minor  characters and this results in inability to follow the plot.    

              To avoid unpleasant consequences, many faceblind people just  choose to withdraw from society  and live like hermits .  

How prosopagnosics   deal with their impairment 

               Every day is a battle for face blind people but they can cope. They have to cope  to survive.

People with prosopagnosia learn  how to compensate for their deficit through other means . They learn by studying other ways of identifying   people : voice , gait , body type , scent and unique  hair style.  

Faceblind people also cope by making intelligent predictions   through  location  and context. For example  , that person in front of the class must be Mrs. Sommers , the teacher. That boy holding a bundle of newspaper must be Ben , the newspaper boy.  The man at the  driver’s seat must be  Mr. Woods , the bus driver.

             To avoid  offending people , some  prosopagnosics master the art of pretension.  They act extra nice ,  greet everybody cheerfully , pretend that they know the person and bluff their way around  . 

The Best Way

             The best way to cope with the ailment is through  an honest and frank  confession.  Prosopagnosics  should  tell friends , especially the new ones , that they have a special condition called face blindness that prevents them from recognizing people . One good technique to explain the ailment to normal people is by comparing it color blindness. Color blind people can  see colors but they can’t distinguish  red from yellow , or blue from violet. Using the analogy , face blind people can  see faces  but they  can’t distinguish one from the other . A  face blind person can tell his  friends : “ If we see each other and I ignore you   , it does not mean that I hate you. It’s just my impairment . I can’t recognize faces. Don’t feel offended. So , please , the next time you see me , please greet me , mention my name and  then mention your name. Then , I will know. ” Most  normal people are sympathetic and make the necessary adjustments  when they are properly informed .

 Is there a cure  for prosopagnosia ?

              Prosopagnosia is still an incurable disease.  Scientists are still trying to discover ways to prevent and to cure the disease. The only concrete accomplishment   is  that  patients are being taught effective compensatory  skills (i.e. , identifying people through  voice , etc. ) to be able to cope well with their surroundings. Compared with other illnesses that have been uncovered in this world , prosopagnosia  has remained a mysterious , hooded  disease in the realms of  science  and of human existence .

Works Cited

Choisser, B. ( 1997 ). Face blind!  Viewed on  www.choisser.com  on September 21, 2012.

Sacks, O.  (2010  August  30 ). A Neurologist’s Notebook: Faceblind. The New Yorker . 36.

Song,  S. ( 2006 July 17 ) Do I Know You ? Viewed on www.times.com on September 15, 2012.

My Religion

I  am an introvert. I thrive in solitude . I hunger for it . When I say solitude , I mean , optional solitude. Being alone by choice . Not the kind of solitude imposed  on Al Capone and other notorious criminals  when they were condemned at the   Alcatraz  prison in the USA  .Nor is it  the kind of solitude that nature  has bestowed  on the natives  of   La Rinconada ,  a town surrounded by permanently frozen glacier  in the Peruvian Andes. At 17,000 feet above sea level , it is one of the farthest  and most inaccessible inhabited   places  on earth .

Not that kind. What I  mean is  the kind of solitude that I can get out of whenever I want to---without any threat  to my safety .

No , I am not   a depressed , lonely person . Far from that . I derive happiness from  the emptiness of  a room .  I feel  genuine pleasure  when I hear my  own footsteps  as I walk alone  in a  park on early mornings. I hold my breath in  delighted suspense as I flip through the pages of  an unearthed  book in a basement .

My room is not  necessarily  quiet . I go for loud  rock music.  I love Guns ‘N Roses , The Beatles  and Bruce Springsteen. I alternate their music with that of Tracy Chapman  and  Jason Mraz . That makes it clear . An introvert  like me does not necessarily go for Beethoven or Bach . Some do . I don’t.

I am not a misanthrope.  I don’t hate people. I like people but in  dribs and drabs . I have  friends , but I don’t hang out with  all of them at the same time in one single place . I prefer to meet them in small clusters. A  cozy , intimate talk with one  or two  friends is better  for me  than a shallow  chatter with a crowd of acquaintances . I avoid big social gatherings that have no professional value . After an hour in a party , I get depressed . Something in my core starts yearning  for solitude .  After two hours , I may get suicidal .So , if I try to leave a party early , please don’t stop me . Unless you want me dead.

  Like extraverts , I can interact well  with people . I can develop healthy relationships with colleagues  at work. Contrary to stereotypes ,  I am not shy nor do  I  feel inferior .  I can confidently  give a speech or a presentation , if I want to.  Or if my boss twists my arms into it. 

             I am often silent . But don't be fooled by my silence . I can have a conversation with you  for hours on a topic we mutually enjoy. I am not often seen .  But  don’t be fooled by my  invisibility . Never.  I can hear everything , from the faintest echo  to the  loudest cry  . I  can see everything , from the flimsiest cobweb  to the most cunningly hidden motive  . I take everything in. Everything. Then I reflect on it, usually with amusement , when I  retreat  to the  temple  of ---  as  the great English writer  Aldous Huxley aptly puts it ---the religion  of solitude.