Human beings rely on being able to recognise other people by their faces for normal social interaction. Lucy Hunter talked to three prosopagnosics, people who have difficulty recognising faces, about some of the problems their condition causes in their everyday lives.
“He’s got one of those faces your eyes just slide off,” said twelve year old Cindy, trying to describe a boy to a friend. The friend didn’t know what she was talking about. A few years later at high school, her best friend had a new boyfriend who Cindy had met a couple of times and thought was an idiot. One night they were at a party and Cindy nudged her friend and pointed, “look at that blond guy. He’s so cute.” Cindy asked if she knew who he was. “She thought I was making a bad joke – it was her new boyfriend.”
Most people are able to identify familiar faces without thinking about it, and many people can identify thousands of individual faces. Our brains have evolved to pay special attention to the nuances of faces, and this expertise is nearly universal, not only in humans but in other primates. Everybody mistakes somebody for someone else or forgets a face on occasion. But up to one in 50 people struggle to identify people by their faces. In the worst cases, a person may not recognise their spouse, their child, or even their own face in the mirror. The condition is called prosopagnosia, or face blindness, and it can make living a normal, social life very difficult. The people I spoke to have milder cases, and are able to function and socialise fairly normally. Severe prosopagnosia can cause enormous problems for those affected by it, including social isolation and depression.
To get an idea of what it is like, imagine that instead of telling people apart, you were trying to remember the differences in individual sheep. You can see the sheep just fine, but if you met a sheep once, could you pick her out of a flock? Would you recognise her if she dyed her wool or lost a lot of weight? Or if she popped up in a paddock you didn’t expect to see her in? This is what it can be like for people with prosopagnosia trying to tell humans apart.
The word “prosopagnosia” is from the Greek: “prosopon” (face), and “agnosia” (not knowing). This is a more accurate term than “face blindness”: people with face blindness can see faces, but they have difficulty remembering them. Damage to the occipito-temporal lobe can cause prosopagnosia, but many people appear to suffer from it from birth. The condition seems to be hereditary, with most congenital prosopagnosics having a close family member with the same condition.
You may have some degree of prosopagnosia if you can relate to the following situations: if you have failed to recognise a close friend or family member, especially when you weren’t expecting to see them, if you tend to remember people you are introduced to by their hairstyle, voice, or a feature other than their face, if you confuse characters in movies or on television more than other people, if have failed to recognise yourself in the mirror and/or have difficulty identifying yourself in photographs, if you usually don’t recognise people who greet you in the street or if they get a haircut, and if you have difficulty recognising neighbors, friends, coworkers, clients, schoolmates etc. out of context.
Cindy (not her real name) has moderate prosopagnosia. She can function and socialise normally most of the time, but finds the condition frustrating and embarrassing. “As a kid I don’t think I could see faces as well as I do now. I remember my early childhood as a vague kind of blur of humanoid blobs and disorientation. Now, once I have met someone about five or ten times, their face usually sinks into my brain.” Sometimes her brain erases faces at random. If she meets someone who reminds her of someone else, her brain overwrites their face with that of the person they remind her of.
Dunedin art student Caitlin Lester and Wellington musician Jon Lemmon also have the condition. Caitlin is particularly bad at telling men apart, especially when they have what she calls “generic man faces.” Caitlin, Jon, and Cindy all have a hard time watching movies, especially gangster movies, where all the characters are men with the same hair and wear suits. Cindy told me “my boyfriend accused me of racism because I couldn’t tell the Italian actors apart.” Caitlin’s face blindness can be an inconvenience, like the time she hitchhiked with an older couple. “We stopped off in Temuka for a cup of tea and I split up with them to go to an op shop. Then I realised I wouldn’t be able to recognise them.” Caitlin ended up waving at and greeting a strange woman. Eventually the old couple found her.
Cindy, Caitlin, and Jon are social and love meeting new people. They have all had times when they’ve made a new buddy at a party, had a long conversation with them, and then completely forgotten what they look like. Caitlin will sometimes be at a party and look around at all the faces feeling bewildered about who she should talk to thinking: “which ones are my friends, again?” Jon said sometimes when he is talking to someone at a party he will be thinking, “okay, the person I’m currently talking to is either Sarah or Rebecca. Now how am I gonna figure out which person it is?” and has to wait until they give away a “clue”. “It’s weird cause I might know both of them fairly well, I just can’t tell them apart when I see one of them at a party.” Jon has a friend with the same problem who told him he kept seeing these two guys at parties he went to, and one of them he really liked, and one of them he couldn’t stand. A year later he found out they were the same person. Cindy once hugged a random man in the street thinking he was her friend.
Famous prosopagnosics include Brad Pitt, Jane Goodall, the late Oliver Sacks, and the artist Chuck Close. Close has severe face blindness; part of the reason he chooses to paint enormous, photorealistic human faces. Sacks wrote a book called “The Man who Mistook His Wife for a Hat” about a Dr. P., who had a severe visual agnosia. He couldn’t recognise faces or facial expressions. Moreover, he could not identify, or even categorise, objects, so was unable to recognise a glove, to distinguish it as an article of clothing, or to perceive that it resembled a hand. As he was writing the book, Sacks realised he related to Dr. P., and on publishing the book he received letters from people who couldn’t tell their friends and family apart. He realised prosopagnosia could be on a spectrum, with far more people than previously known living normal lives with milder versions of the condition.
Prosopagnosics often have trouble with navigation. Cindy says “I can drive, but I don’t like doing it.” Driving alone she is fairly happy to potter around, lost, but relies on passengers to navigate to when she has company to avoid wrong turns. Walking is no different. “My friend and I meet for coffee every week and I get lost going to the café. It’s on a weird intersection.” Cindy remembers driving with her mum to a friend’s house to pick something up. She’d been there probably 20 times, but couldn’t remember which house it was, or even if they were on the right block. “My mum was mad cos we were in a hurry. I was staring at this house for ages but I just couldn’t remember if it was the right one. All the houses looked exactly the same. It’s embarrassing.” Jon said “I never know which street to turn down in Wellington when I’m trying to get somewhere and I always get really confused when other people instinctively know which street to turn on.”
Sacks wrote about similar problems with navigation. He tells a story about going for a walk with his nephew who was staying with him and getting lost trying to get home. “After two hours of walking around, during which we both got thoroughly soaked, I heard a shout. It was my landlord; he said that he had seen me pass the house three or four times, apparently failing to recognise it.”
Cindy eventually went to a doctor, worried she had some kind of dementia after getting lost walking home. The doctor asked her how her memory for other things was - studying for exams, remembering events, etc. They were all fine. The doctor suggested she may have face blindness. “I felt a lot happier having a name for it, and knowing I wasn’t going crazy or senile.” Caitlin is also not as bothered by her prosopagnosia since putting a name to it a year or so ago. She learned about it when talking to a flatmate who had similar problems to her. “Everything made sense for me.”
Face blindness can make a person seem rude, aloof, or snobby. Sacks was accused of absent-mindedness, shyness, reclusiveness, social ineptitude, eccentricity, even of having Asperger’s syndrome. He believed these assumptions were at least in part consequences of his difficulty recognising faces.
Prosopagnosics tend to develop strategies for identifying people. They get good at remembering voices, gait, context, and physical attributes like hair colour and clothing style, even jewellery. But the condition makes some people avoid large social events for fear of embarrassment. Sacks avoided conferences, parties, and large gatherings as much as he could to avoid anxiety and embarrassing situations if he failed to recognise people he knew. Like Sacks, Caitlin, Jon, and Cindy tend to greet strangers as old friends. They avoid greeting people by name and often depend on others to save them from the worst of their social blunders.
Caitlin once made a new friend at a party who she was getting on well with. After about half an hour she had “a click moment” and realised that this wasn’t a new friend at all - it was an old friend who had cut off his dreadlocks. She remembers some people better than others, and finds people with “ordinary faces” and conventionally attractive faces harder to remember than others. “I’ve noticed a lot of my friends are quite unusual looking. Maybe I subconsciously pick friends who have interesting faces.” Cindy sometimes has trouble with even her friends, especially if they are “out of context” or not in a place where she expects them to be. “One of my best friends came to visit me in the office. She had different hair and I didn’t recognise her.” Jon once introduced himself to a “new girl” at work, and she said to him “Jon, are you serious?! We’ve been working in the same office for the past year.” Turns out she’d just cut her hair.
Some prosopagnosics have trouble recognising their own spouses. Cindy isn’t that bad, but she says “One time my boyfriend shaved his hair completely off. He had warned me about it, but when I saw him I didn’t recognise him for a while. Like, for a few seconds.” She also remembers having a huge crush on an old boyfriend, going to meet him at a bar, but then not being sure which one he was. “I was so crazy about him, and I knew I found him attractive, but I couldn’t figure out which man was him. I was looking at all these guys thinking are you my crush? Or is it you?”
After failing to recognise a friend at a music festival, Caitlin found a temporary solution to her problem. He was a friend Caitlin had failed to recognise a lot, and it offended him. “He was one of those “faceless” people who I couldn’t keep hold of. It was particularly embarrassing cos I saw him every week or so. My whole body flushed. I felt like dying.” Caitlin made a sign and put it on her back, stitched to her overalls. It said “I’m sorry, I often have trouble recognising faces. Please re-introduce yourself to me and don’t be offended if I don’t recognise you.” She said the response was positive and it generated a lot of conversation “because people don’t know about this. They think you’re just being rude or don’t care about them.” Jon has thought of doing something similar. “People take it really personally when you don’t recognise them. And when you say “Sorry, I’ve got facial blindness” it sounds so ridiculous they don’t believe you. There’s a real lack of awareness about the condition. I thought about making a card I could pull out at social occasions that says “I’m sorry” on one side, and on the other side it explains what prosopagnosia is.”
Prosopagnosia can make you a better person. Many face blind people are friendly and welcoming to everyone they meet, because they don’t know if they are a friend or a stranger. Jon said “The main way I cope with it is by smiling at everyone I see and pretending like I know them already, because chances are I might. It’s not too bad really, it’s nice to pretend like everyone is your friend.” But Cindy doesn’t like it. She says “It’s different to being bad with faces. I can feel my brain mucking things up for me. People think I’m stupid or snobby.” Next time someone you know fails to recognise you, consider that the situation may be far worse for them than it is for you.