People who suffer from prosopagnosia are unable to recognize someone they know personally by their face. In German usage, this disease is also called face blindness.
What is face blindness?
There are several different forms of prosopagnosia: apperceptive, associative and congenital prosopagnosia. The congenital form is congenital face blindness.
Most affected people are not even aware of their condition because they consider this condition to be normal. They cannot understand that other people can perceive faces differently. See gradphysics for HHL in English.
People with apperceptive prosopagnosia are unable to judge a person’s age from a face. They also cannot read the gender of the person from the face. In addition, facial features make it difficult for them to infer a person’s emotions.
People who suffer from associative prosopagnosia, on the other hand, can infer the person’s age and gender when looking at a face. A specific assignment, such as recognizing prominent people, is not possible for them either.
The cause of congenital prosopagnosia, i.e. the congenital form of face blindness, has not yet been fully clarified. Altered genetic information could be a possible trigger. For example, the mutation of a gene that is responsible for the function of brain nerve cells.
In the case of severe face blindness, it can also happen that it is not possible to distinguish between people and objects. Multiple areas of the brain are often damaged. The congenital form of face blindness is an inherited disorder and is sometimes associated with autism or Asperger’s syndrome.
The cause of apperceptive and associative prosopagnosia is damage to the brain. This can occur as a result of a disease such as a stroke or a traumatic injury. The degree of damage has an impact on the severity of face blindness.
Symptoms, Ailments & Signs
The clinical picture of prosopagnosia decides on the symptoms associated with this partial inefficiency. First of all, almost all sufferers of face blindness are able to recognize a face. The other information that can be gleaned from the face varies. Also, some face-blind people can only remember faces for a very short time.
Apperceptive prosopagnostics cannot derive information such as age or gender from a face. Reading out emotions causes them great problems. A featured face of a known person does not link to any other information about that person. Associative prosopagnostics can distinguish faces, assign gender and age, but cannot retrieve any further information.
Congenital prosopagnostics can experience their face blindness in different ways. It ranges from the complete inability to recognize faces to weaknesses in classification. Since this is innate, however, compensation strategies are usually created, which is why the limitations are minor. If there are also problems with recognizing emotions, the behavior is occasionally reminiscent of the symptoms of Asperger ‘s.
Signs of some form of face blindness include difficulty remembering faces and the inability to infer a person from a face. Even if people who are actually known are difficult to recognize in a changed context, this can also be a sign.
Diagnosis & History
Diagnosing congenital face blindness is not easy in practice. As a rule, the people affected automatically develop ways of recognizing the people in their environment by other characteristics.
For example, a special hairstyle, clothing or even the voice and movements of a specific person are assigned. Outsiders often do not notice that the face of the person was not decisive for recognition. If there is frequent confusion between familiar people, this can be a sign of prosopagnosia.
Those affected often do not look their fellow human beings in the face because this seems completely uninteresting to them. A young child’s lack of eye contact can also indicate other conditions such as autism and is not a sure sign of face blindness.
In the case of forms of face blindness acquired through accident, injury or illness, the people affected and those they relate to recognize that their perception and ability to assign faces to people has changed.
Visual agnosia or prosopagnosia is a severe acquired or congenital condition. Those affected have to reckon with complications in their lives throughout their lives. Social interaction is problematic in congenital face blindness. Those affected do not recognize people they should know.
With acquired face blindness, recognizing familiar people has become impossible. Those affected have to learn to classify their counterpart due to changed strategies, otherwise there is a risk of social isolation. The biggest problem is that those affected are not recognizable as faceblind to those around them. This leads to numerous misunderstandings and complications. In the case of prosopagnosia, those affected cannot correctly assign objects, even though they are often highly gifted.
In the most severe form of face blindness, acquired apperceptive prosopagnosia, those affected cannot even correctly identify the age or gender of the other person. Often triggered by severe head injuries, strokes or brain tumors, additional complications can occur in face-blind people. These are due to the existing brain damage.
Depending on the severity of the prosopagnosia, the severity of the possible complications can also vary. In the most severe degree, those affected only recognize shadowy forms. For example, parking meters can be mistaken for faces because of their shape. Because of their size, they are kept for children or young people. A myriad of problems arise from this.
When should you go to the doctor?
If abnormalities in the processing of perception are noticed in everyday life, a review of the sensory impressions is necessary. In many cases, prosopagnosia goes unnoticed for a long time. The disease is already present at birth, so that the affected person is initially unaware of the impairment of vision. People are often recognized as a matter of course by their voice, physical build or clothing.
Therefore, the illness often requires the help and support of people in the immediate vicinity. If the person concerned cannot adequately describe the face of another person when asked directly, a doctor must be consulted.
Prosopagnosia is limited to a disorder of face recognition. Therefore, all other visual sensations can be fully processed and recognized. This makes it difficult to discover the existing disorder in everyday life. Children should generally be presented to a doctor for regular check-ups in their first years of life. This is especially true if the disease has already occurred in the family.
Treatment & Therapy
There is no therapy that can cure face blindness. However, those affected can learn certain strategies in order to be able to reliably assign the people in their environment. A neuropsychologist can provide guidance on this.
In order to achieve optimal results, the skills must be trained again and again. Many other elements can be used to identify people. This can be, for example, the person’s voice, gait, stature or posture. Gestures can also be included.
In addition, information about clothing, hairstyle or physical characteristics such as scars can be helpful. Certain objects belonging to the person, such as a watch, jewelry or glasses, also make it easier to recognize. Face blind people who train these skills are often able to recognize specific people in the environment in which they typically encounter them. For example, they can tell their colleagues apart in the office.
However, if you meet these people somewhere else, such as in a shopping center or in a restaurant, it takes much longer to recognize them or it is sometimes even impossible. People with the congenital form of prosopagnosia benefit from early detection of the disease. Parents and other caregivers can then specifically promote learning of the alternative assignment options.
Prevention is not possible with any of the three forms of prosopagnosia described . One can only try to minimize the known risk factors for stroke and other diseases through a healthy lifestyle. Many head injuries can be prevented by wearing a crash helmet.
The extent of an existing prosopagnosia cannot be reduced by special follow-up care. The main goal now is that those affected can cope well with their everyday life with face blindness and lead a relatively normal life. In the case of congenital prosopagnosia, dealing with the limitation is much easier than if the disorder was caused by an accident or illness, for example.
The same can be observed with other disabilities such as blindness or deafness. Patients who were born with face blindness have already acquired other strategies in early childhood with which they can tell different people apart to a certain extent.
This also explains why many prosopagnostics are often not even aware that they are affected by this disorder. In such cases, no follow-up care is usually required and is usually not desired by those affected. If prosopagnosia occurs later, however, alternative detection strategies have to be learned with great effort.
Targeted training can help here under certain circumstances, but it is not part of standard aftercare. In some regions and on the Internet there are also self-help groups for those affected. Here, patients have the opportunity to exchange ideas with other prosopagnostics. Just the certainty of not being alone with the limitation can significantly improve the quality of life of those affected.
You can do that yourself
Prosopagnosia (face blindness) cannot be corrected. However, many of those affected develop strategies at an early stage to compensate for the inability to recognize faces by developing other skills.
With a lot of training, prosopagnostics can learn how to recognize a corresponding person using other characteristics. Such characteristics concern, among other things, the voice, the gait or the gestures. Hair style, specific scars or birthmarks, specific glasses and other characteristics often also play a role. Sometimes a written or mental list helps to find out which people can be met in certain places with certain characteristics. If other characteristics then match, the person can be identified. The development of these skills is absolutely necessary for those affected to find their way in the social environment. Training these skills can be done under the guidance of a neuropsychologistbe performed.
In order to avoid exclusion, it sometimes also helps to disclose the problems in the family or among close acquaintances. In this way, at least, the accusation of being unfriendly, impolite or ignorant can be refuted. There are also self-help groups for prosopagnostics, in which experiences in dealing with the environment can be exchanged. Furthermore, the exchange of interesting strategies for recognition takes place here. You can search for these self-help groups and make contacts on the Internet, among other places.