Prosopagnosia: I See You and I Know You, But I Don't Recognize Your Face

Prosopagnosia is a rare disease that currently affects 2.5% of the population. It has affected some very well-known people, like actor Brad Pitt, the co-founder of Apple, Steve Wozniak, and neurologist Oliver Sacks, who recently passed away. People with this disorder are incapable of recognizing faces, including their own. Have you ever thought about what your life would be like if you had “facial blindness”?

Imagine you’re walking the dog and you run into your best friend, but you don’t say “hi” because you don’t know who she is. Think about going to say goodnight to your children, but you can’t recognize their faces. Or going to the office and your coworkers seem like complete strangers.

For someone who has prosopagnosia, the day is this complicated. And actually, people with the disorder often aren’t aware that they have it. 

Who are you? And who am I?

This disorder doesn’t just hinder facial recognition of close family, friends, and acquaintances. It can even affect identification of emotional expressions and gender. All faces look the same, with no distinction.

That’s why a person in the social circle of a person with prosopagnosia might feel hurt by him. They have shared so many experiences, and now he doesn’t even recognize her. In fact, actor Brad Pitt has said as much. He said because of his disorder, people very close to him have written him off as self-centered and arrogant.

In the most serious cases, the person isn’t even capable of recognizing himself in a mirror or a group photograph. This can have very negative consequences. Not only in interpersonal relationships but also in the workplace. It can affect self-esteem, and even cause depression.

Some believe that it is a memory problem

The term comes from the Greek prosopon (face) and agnosia (absence of knowledge). People who suffer from it have perfectly good vision. They can remember and recognize most objects reasonably well. That’s why, just like any healthy person, they know who their parents are, their children’s favorite color, their partner’s likes and dislikes, what they ate yesterday, or how well their roommate sings.

Though the areas of the brain that process faces are in constant interaction with the neuronal networks of memory, it’s not a memory problem per se. It is more an illness that is specifically related to faces. 

We perceive a general model of faces

Before learning how to talk or even babble, babies instinctively notice faces. By the time they are four months old, they process faces in a clearly defined way. This is due to the fact that faces are extremely informative. Faces reflect emotions, feelings, identity, sex, and ethnicity.

A person with prosopagnosia can identify different parts of the face (nose, eyes, mouth, etc.). But they aren’t capable of remembering their exact location on the face. Nor can they put together complete facial structure. They can’t convert facial features into a unique pattern of traits.  They can’t associate facial features with a person’s identity.

This happens because faces are processed all together, not in parts. That is to say, we can’t identify someone by just their eyes or their mouth. Because we can get so much information from a person’s face, we are able to simultaneously take it all in and create a generalized model of a face.

The solution is to use contextual clues

An inability to recognize faces is the trait of prosopagnosia that stands out the most. However, in some cases people with the disorder can recognize faces of people who are close to them. They can do it as long as the faces stand out from the crowd because of some specific feature.

In this way, they use different contextual clues and strategies to ease potentially embarrassing situations. They can deduce who they have in front of them by noticing some characteristic detail of the person. Some examples are: noticing hair color or glasses or the way someone walks. Other clues are skin tone, unique scars, moles, or voice quality.

The more noticeable the feature, the quicker and easier it will be to identify them. Very thick eyebrows, ears that are really far apart, neon green glasses, a strong perfume, etc. All of these traits can help a person with prosopagnosia identify those around them.

Are you born with prosopagnosia?

This disease can present at birth. It can be hereditary and be passed from generation to generation, though this isn’t common. In the majority of cases,  brain damage in both hemispheres causes the  disorder. This can be a result of a stroke or a brain tumor. Less often, it is a result of cranioencephalic trauma or infections like encephalitis that affect the central nervous system.

Facial perception requires cognitive processes in different areas and brain structures. However, there is a region of the brain that is specifically in charge of facial feature recognition: the Fusiform Face Area (FFA). It is located in the temporal lobe, in the Fusiform Gyrus.

What kinds of treatments are there?

There is no effective treatment for prosopagnosia. Nevertheless, doctors can train their patients to use contextual clues. Experts also recommend that the people around them make their day-to-day as easy as possible. For example, saying the name of everyone present, and avoiding big crowds and parties or movies with too many characters.

Now you know a bit more about this little-known illness. It affects quite a few people and makes them blind to faces. What do you think about it?