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By C. L. Marvelli

“I see the face and the eyes and the mouth, But not the soul behind.”

~ Rudyard Kipling

In 1947, a German psychologist named Joachim Bodamer published the first paper on a neurological disorder that was first recognized dating back to the 9th century. Bodamer described patients who had an inability to recognize faces. He gave this disorder the name Prosopagnosia but today, many refer to it as face blindness (CBS News- 2012). Since Bodamer’s paper, prosopagnosia has been researched extensively. Antonio R. Damasio hypothesized that, “Physiopathologically, prosopagnosia is the result of a failure to activate, on the basis of visual stimuli, memories pertinent to those stimuli” (Damasio, 1985). Prosopagnosia can be caused by injury (stroke, TBI), abnormalities (congenital), and neurodegenerative diseases. It is also observed in children with autism (National Institute of Neurological Disorders and Prosopagnosia Research (NINDPR), 2007). Damasio’s research, as well as many others, has discovered that lesions involved in acquired prosopagnosia “Are usually found in ventral occipito-temporal cortex, involving both or either of the inferior occipital and fusiform gyri” (Schiltz, Sorger, Caldara, Ahmed, Mayer, Goebel, & Rossion, 2006). People can have this disorder in varying degrees. Some people cannot recognize faces of people close to them; spouses, children, or close friends, while others cannot recognize objects like cars or even animals (NINDPR, 2007). For most, this poses the particularly difficult challenge of finding alternative ways to identify people. Some rely on visual cues like moles in a specific place on the face, mustaches, or bushy eyebrows. Some rely on the sound of a person’s voice, the color of a person’s hair, hair length or hairstyle (CBS News, 2012). Many people don’t even know they have it. Neurologist and author Oliver Sacks said on a 60 Minutes segment on CBS News, that he apologized to himself once after seeing himself in a mirror. Now, he looks to his large ears for a quick reference (CBS News, 2012). Sacks had written about the subject in his book; The Man Who Mistook His Wife for a Hat.  In one of the short stories of the same name, Sacks talks of a patient he refers to as Dr. P. He describes Dr. P. as a man with “No persona in this sense – no outward persona, and no person within” (Sacks, 1985). Perhaps, in no small way he sees himself in Dr. P.

The question for some: Is prosopagnosia caused by a memory deficit or is it a problem in perception? Mike Takamura concludes, in his article, Prosopagnosia: A look at the laterality and specificity issues using evidence from neuropsychology and neurophysiology, that “Prosopagnosia can and should be seen as both a perceptual and memory deficit, depending on which stage visual processing the lesion occurs,” and that “The right hemisphere is the more efficient at face processing, in order for a complete loss of facial processing, a bilateral lesion must occur” (Takamura, 1996). Most researchers tend to agree that damage to the fusiform gyrus; a region of “The brain where the occipital and temporal cortices meet” (Breedlove, Watson, & Rosenzweig, 2010), causes most cases of prosopagnosia. The disorder can run from mild to severe, with people on the severe end exhibiting other types of agnosia’s, like those who cannot recognize their own car, for instance. For these people, daily life can be one confusing incident after another. For others, they simply retreat to avoid embarrassment and shame. Of those who suffer from complete face blindness, negative social implications arise when others perceive them as being rude or even just plain stupid. Problems in the workplace can also arise, and this can lead to “more limited employment opportunities, and loss of self-confidence” (Duchaine, Yardley, McDermott, Pisarski & Nakayama, 2008). Not being able to recognize a family member may not be as complicated if one learns to use audio cues or other visual cues, but for strangers and even co-workers, complications can arise that can be, not only uncomfortable, but damaging. There is no treatment available for prosopagnosia with the exception of programs used to help to enhance facial and other recognition factors (NINDPR, 2007).

References:

Damasio, A. (1985). Prosopagnosia. Trends in Neurosciences, Volume 8, 1985, Pages 132-135. Retrieved at http://www.sciencedirect.com/science/article/pii/0166223685900517

Duchaine, B., L. Yardley, L. McDermott, S. Pisarski, & K. Nakayama. (2008). Psychosocial consequences of developmental prosopagnosia: A problem of recognition. The Journal of Psychosomatic Research: 65 (2008), 445-451. Retrieved at http://www.faceblind.org/social_perception/paper /yardley08jpsychosomres

Breedlove, M, N. Watson, & M. Rosenzweig. (2010). Biology of the Brain. (7th ed). Sinauer Associates, Inc.

Face Blindness Part One. (2012). 60 Minutes: CBS News. Retrieved at http://www.cbsnews.com/video/watch/?id=7417242n

Face Blindness Part Two. (2012). 60 Minutes: CBS News. Retrieved at http://www.cbsnews.com/video/watch/?id=7417240n

Prosopagnosia Information Page. (2007). National Institute of Neurological Disorders and Prosopagnosia Research. Information about prosopagnosia. Retrieved at http://prosopagnosiaresearch.org/index/information

Sacks, O. (1985). The man who mistook his wife for a hat: And other clinical tales. Summit Books. ISBN 0-671-55471-9.

Schiltz, C., B. Sorger, R. Caldara, F. Ahmed, E. Mayer, R. Goebel, & B. Rossion. (2006). Impaired Face Discrimination in Acquired Prosopagnosia Is Associated with Abnormal Response to Individual Faces in the Right Middle Fusiform Gyrus. Cerebral Cortex, April 2006; 16 (4): 574-586. Retrieved at http://cercor.oxfordjournals.org/content/16/4/574.full.pdf+html

Takamura, M. (1996). Prosopagnosia: A look at the laterality and specificity issues using evidence from neuropsychology and neurophysiology. The Harvard Brain. Retrieved at http://www.hcs.harvard.edu/~hsmbb/BRAIN/vol3/pdf/b96_6.pdf

Yardley, L., L. McDermott, S. Pisarski, B. Duchaine, K. Nakayama. (2008). Psychosocial consequences of developmental prosopagnosia: A problem of recognition, Journal of Psychosomatic Research, Volume 65, Issue 5, November 2008, Pages 445-451. Retrieved at http://www.sciencedirect.com/science/article/pii/S0022399908001578

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