Do I Know You? Face Blindness after Brain Injury

Face Blindness after Brain Injury
Original Image from Nhân sự Việt Nam. T. An(theo ABC)

 

Face Blindness,(Prosopagnosia) is the lack of ability to recognise faces. Including people who are very familiar; sometimes even your own face.

Today the focus is on Prosopagnosia, more commonly known as ‘Face Blindness’ after brain injury, other causes are also mentioned below. While the cause may be different, the outcome is similar.

 About Prosopagnosia or Face Blindness

Over the past two weeks we talked about left brain right brain along with  left and right brain function. Prosopagnosia, or face blindness as I will call it from here on in, was an example of what can happen when damage occurs.

Reading about Prosopagnosia got me thinking. While I have met people who have face blindness after brain injury, I knew very little about it. Today I share what I have learned on my week of exploration.

Some early learnings, I believe key points, that came to me while exploring face blindness were:

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a) This is not a person being rude or unsociable. It is a change in, or damage to the brain, that stops the recognition of faces.

b) It is not uncommon for people who have face blindness to withdraw socially, to protect themselves, and protect people close to them, from the effects.

c) This must be very distressing for partners, family and friends. To be close to a person, maybe even providing significant support, yet day in day out they do not remember your face.

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In the following interview with Dr Oliver Sachs, he describes face blindness. This includes the origins of the term ‘Prosopagnosia’. “Prosopo” from the Greek word for face and “Agnosia” – meaning to not recognise.

 

How Facial Recognition Happens:

Throughout discussion about the brain we learn a strong message: All parts of the brain work together. While specific functions happen in either the  left or right hemispheres of the brain, recognising faces relies on a number of areas in the brain working together to carry out the tasks needed.

To recognise a face our brain draws on a range of tasks that includes:

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  • being able to determine if the face is new, or familiar
  • remembering what place and context we know it from
  • identifying whose face the combination of features make up
  • deciding the name of the person who belongs to the face.

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It is thought that the temporal lobe is important in face recognition, with different functions in the left and right temporal lobes working together with other parts of the brain.

The article Have We Met Before gives brief insights into the range of functions, including memory and the parts of the brain that help us recognise a face.

 Our Amazing Ability to Recognise Faces

Mostly we do not even think about our ability to recognise faces yet we can recognise faces:

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  • of the people we know and love,
  • of acquaintances and people we might meet rarely
  • of well known people we have never met, who may even be from past centuries
  • when a feature / s is changed for instance; wearing or not wearing glasses, and makeup.
  • faces upside down, from distorted images, at all angles and even from individual features
  • How Does Our Brain Know What Is a Face and What’s Not?  We recognise when we see a real face, and when it is a model, cartoon or other image. This article also explains a little more about the close workings of left and right brain while having slightly different functions in recognising faces.

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It is a complex and difficult task for the brain.

We can recognise MANY faces and we think each face is very different

Yet the features of a face are limited in number!

And they are generally pretty similar.

Causes of Face Blindness

Face Blindness after brain injury.

Causes include stroke, dementia, tumour, neurological disease and trauma. HERE  are stories of David, and Sandra, both living with face blindness after brain injury.

Congenital

A small percentage of the general population have proposagnosia, sometimes managing it throughout life without ever discussing it with others. It is thought to be a congenital disorder.

Autism

It can also occur in people with Aspergers syndrome and Autism.

How Face Blindness Might Present:

As with many outcomes, face blindness after brain injury can present in different ways and different degrees including:

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  • Not able to recognise familiar faces such as partner, family,and friends
  • Not able to recognise yourself – for instance looking in mirror and not recognising the image
  • Recognising a face but not able to connect it to a name
  • Not able to recognise the emotion, or feeling another person is showing
  • Difficulty following visual media such as movies and television programs because of difficulty recognising and remembering characters.
  • Not able to recognise objects
  • Not able to connect the individual facial features to the whole to identify the face

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In this next video interview with Dr Oliver Sachs, he gives a surprisingly personal example; describing his own experience of living with Prosopagnosia.

[box style=”rounded” border=”full”]Dr Oliver Sachs on Face Blindness.[/box]

 

Strategies for Managing Face Blindness After Brain Injury

A great start is to understand that face blindness after brain injury exists. People may not disclose their difficulty, or even be aware of it.

Other strategies that may be helpful include:

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  • If in an unchanging environment such as a meeting, dinner, or classroom, write down the names and seating arrangements of people in the room.
  • Suggest family and friends wear something familiar to enable association and identification. In some instances people have used name badges, for some this can be embarrassing.
  • Practice identification using photographs of close family and friends.
  • Where possible ask people to explain who they are and what they are expecting of the communication.
  • Where appropriate briefly explain to people; the difficulty with face recognition, and the difficulty understanding facial expression.
  • Learn the specific features that identify a person for instance voice e.g. style of speech, accent, body features, dress style. An example I read about described a person with prosagnosia who found he graduated towards people who looked different or dressed very differently. He reasoned that this made recognition easier.
  • Explain the issue and ask people to introduce themselves each time.
  • A supporter can assist by quietly prompting with name of person and any other relevant information.
  • Recognise that strategies can be more difficult when in an environment the person cannot control e.g. in a meeting you might write down the names of people present. At a party with people moving around this is not possible.

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Please add any further strategies you have used, or are aware of, in the COMMENTS below.

While there was a significant amount of information on Face Blindness I have not found too much about strategies.

And Finally:

There are some surprising examples of people with face blindness in addition to Dr Oliver Sachs. Artist Chuck Close has face blindness after brain injury; following a stroke, yet paints incredible portraits. His story is also one of incredible courage and resilience.

There is even some suggestions that Brad Pitt has Prosopagnosia. As he explained in an interview in the magazine “Esquire”

 

Further resources can be found at the Prosopagnosia Research Centers website which has a range of links to further information along with an introduction to face blindness.  The site includes a ‘Face Blindness test’ if you are concerned you may have face blindness