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“You don’t look like anyone I know,” a common statement made by someone that has Prosopagnosia. Prosopagnosia or “Face Blindness” is a genetic or in some cases a developmental disorder. “New studies show that Prosopagnosia is highly heritable and surprisingly common, afflicting about 50 million Americans or 1 in 50 people” (Song, “Do I Know You?”). Only recently has this disorder been truly studied extensively, but now programs are conducting more in depth experiments to discover more about this condition. Prosopagnosia has nothing to do with sight; it is strictly a brain disorder. Prosopagnosia is “an impairment in the ability to recognize faces. Usually prosopagnosics are able to actually see the features on a person's visage with no difficulty; it is the retention of those images that challenges them” (Abeddin, “Face Blindness, Not Just Skin Deep”). “Prosopagnosia is a perception failure that occurs between sensory detection and perceptual interpretation” (Meyer, 198). Other types of impairment are often accompanied with Prosopagnosia such as: “place or car recognition, name remembrance and facial expressions of emotions” (Harvard College, “History”). Prosopagnosics can detect facial features such as eyes, noses, and mouths, but they are unable to recognize the same person’s set of features upon seeing them again. “If shown unfamiliar faces, someone with Face Blindness will not react. Shown a familiar face, their autonomic nervous system responds by producing excess perspiration. When seeing themselves in a mirror, one will remain stumped by their reflection” (Meyers, 198). Its first documented case occurred in “Bodamer’s report in 1947. Two individuals were documented in an extensive paper that described their symptoms as being distinct from ‘agnosia.’ Their condition became known as Prosopagnosia. Prosopagnosia is derived from the Greek terms for face (prosopon) and the medical term for recognition impairment (agnosia)” (Harvard College, “History”). “Developmental Prosopagnosia occurs either genetically or prior to developing normal face recognition abilities, which is reached during teen years” (Harvard College). Dr. Thomas Gruter conducted a survey in 2006 for the Institute of Human Genetics in Munster discovering that out of “689 local high school and medical students, seventeen participants were diagnosed with Face Blindness. Further interviews with the families of the fourteen subjects revealed that each had at least one close relative with the same problem. Judging from the patterns of inheritance, there is speculation that Prosopagnosia may be caused by a defect in a single, dominant gene. If one parent has the dominant gene, each child has a fifty percent chance of inheriting it” (Song, “Do I Know You?”). Individuals who experienced brain damage before experiencing faces have typically had immediate brain damage or prenatal brain damage. Acquired Prosopagnosia is due to “brain damage suffered from head traumas, strokes, and degenerative diseases” (Harvard College). Impairment of faces is easily apparent for these individuals to realize because they have experienced face recognition in the past. Another indication is that they have brain damage shown from medical examinations. Typically, one will have “loss of components within their temporal lobe, which is essential to recognizing faces…Acquired Prosopagnosics’ brain damage inhibits them from top-down processing, which is when stored knowledge cannot be translated to sensory input” (Meyers, 198). “Prosopagnosia genetically tends to be handed down in varying amounts, whereas those that have acquired it through injury tend to have it on a grander scale” (earthlink.net, “Prosopagnosia”). The cause of Prosopagnosia is still not truly known. “It is suspected to be linked to the fusiform gyrus, an area of the brain that has been shown to respond to seeing faces” (Abedin, “Face Blindness, Not Just Skin Deep”). Most people that live with Face Blindness often recount feeling lost. They cannot distinguish family, friends or themselves. Looking into a mirror is a difficult task because those with Face Blindness do not know of their own reflection. One woman admits to making funny faces when in public restrooms to differentiate herself from the crowd. “It's a disability that complicates everything from following a movie plot to picking a perp out of a lineup. Prosopagnosics with mild cases can train themselves to memorize a limited number of faces. The memorizing task is like trying to distinguish the difference between stones, it’s all the same” (Song, “Do I Know You?”). Many people are quick to make fundamental attribution errors towards someone with Prosopagnosia. The trouble with Face Blindness is other’s misconceptions that Prosopagnosics are snobby, aloof, lazy, or uncaring. Prosopagnosics have hard times retaining friendships due to others assuming they’re conceited for not remembering them specifically. Diagnosis for Prosopagnosia is in its beginning stages. There are only two forms of testing available. The Benton Facial Recognition Test (BFRT) is designated for clinical and research purposes through neurologists and neuropsychologists. “Subjects are presented with a target face among six other faces of either gender. Subjects are asked out of the six faces, which one is the pair to the target face. The faces are presented on a black background (6.5cm X 6.5cm) with hair and clothing cropped out of the picture. For the first six images presented, only one face matched the target face. When presented seven collective photos, three matched the target image” (Duchaine, Nakayama, “Developmental Prosopagnosia and the Benton Facial Recognition Test”). The Benton holds no content validity because evidence has proven that individuals with Face Blindness can score within a normal range. Those that ‘pass’ rely on “feature matching (hairline, eyebrows, nose shape) as opposed to holistic processing used by individuals with normal face recognition” (Duchaine, Nakayam). The indication that Prosopagnosics were using a heuristic to pass the test was when they requested more time. “This test discovered that there are two types of recognition processes, dissociative face recognition and familiar face recognition (seeing an acquaintance or a celebrities’ image). Both suggest that recognition is handled through different forms of one’s model of face processing” (Duchaine, Nakayam). The best measurement for Prosopagnosia is the Cambridge Face Memory Test because it has good reliability and effectively discriminates between people with and without Prosopagnosia. “This test presents photos of celebrity figures for a second then has the participant identity that celebrity. The participant is then told the identity of the person. Depending upon their accuracy, the person is to chose the following response phrases, “Yes, I got this right,” “I got it wrong, yet I’m familiar with this person,” or “I am not familiar with this person” (Sellers, “Accurately Diagnosing Prosopagnosia”). The problem with defining Prosopagnosia is that face recognition is completely cognitive, which complicates means of developing instruments that provide guaranteed diagnosis. As of now, Prosopagnosia is a very broad disorder that is in the beginning stages of being defined. “Developmental Prosopagnosia is a particular syndrome that requires precise testing for the actual problem: the inability to remember the features of the human face. Many clinicians haven't knowingly encountered developmental or acquired cases; their experience is limited to the rare case studies (stroke victims or epileptics) who suffer brain damage and dramatically lose their ability to read faces” (Sellers). The hardest part is for someone born with Face Blindness to actually realize that they have the condition. Testing is very limited and due to that Prosopagnosia will not be recognized in the DSM V. Until a cure is found, people rely off of common cues to help them recognize someone such as: hairstyles, clothing, body language, or voices. Some people engage in the “buddy system.” “In social settings, someone with Face Blindness might use a companion to help identify others to avoid embarrassment. Others avoid parties or large gatherings altogether, opting for more intimate opportunities instead” (Abedin, “Face Blindness, Not Just Skin Deep”). With the internet, people seek solace with others that are experiencing the same difficulties. Many online forums provide Prosopagnosics comfort with their condition and a sense of not feeling alone. The promising aspect of living with Face Blindness is that the brain (with much practice) can be trained to remember people’s faces by incorporating plasticity of neural circuits to adapt the creation of new memories.
Contributed by Triss Dryl