Download the PDF of Inclusion- Face Value
In his book The Mind’s Eye (Picador 2010), eminent British neurologist and prolific author Oliver Sacks writes, ‘Being social beings we need to recognise each other and we do so in all sorts of ways: by the way people move, the way they dress, their voices, where they are, but particularly we are very good at recognising people’s faces. Well, when I say we I mean the majority of people. There are some people who are not so good at recognising faces and, in extreme cases, people may not recognise their husband, their wife, their children, their oldest friends, and they are called face blind.’
Here, Sacks is talking about prosopagnosia, or face blindness, a neurological condition that very little is known about and is given almost no media coverage, though it is not rare. It is a dysfunction of the visual processing of faces. The reason for this, put at its most simple, is that the features that can be seen on a friend’s or teacher’s face cannot be put together, encoded and stored in the memory as that person’s face. Something that comes ‘instinctively’, so to speak, to most of the population does not to those with prosopagnosia.
The term prosopagnosia was first used in 1944 – ‘prosop’ being the Greek for face and ‘agnosia’ for not recognising. Sacks, who was face blind himself, once said, ‘I often don’t know who I’m talking to.’ He writes in detail about an extreme manifestation of this in The Man Who Mistook his Wife for a Hat (Picador 2011).
ON A SPECTRUM
People can have one of two types of prosopagnosia:
Congenital/developmental prosopagnosia: this means that a person was born with the condition – it is not due to an accident or brain damage.
Acquired prosopagnosia: this results after sustaining brain damage or a stroke, and so is more often found in adults.
It is generally thought that about 2 per cent of the population have prosopagnosia. Sacks, however, speaks about it as being more widespread and on a spectrum. For Sacks, about 80 per cent of the population are somewhere in the middle; at one end are the super-recognisers who seem to have an indelible memory for faces (they can recall a face seen once 50 years ago), and at the other end are the poor recognisers who cannot find themselves, or a person familiar to them, in a photograph. They may not recognise familiar people in a small group or even in their usual daily context such as work or home.
It seems some who have face blindness will perceive themselves as a bit odd, weird, rubbish, and so on. Sacks, however, is concerned that the person who is face blind should not be seen as one of a species apart, but be understood as one of many people on a continuum who experience an aspect of life in a way that is different from most.
LIVING WITH FACE BLINDNESS
Many with prosopagnosia learn compensatory strategies or tricks as a means of recognising others. These include using hair, clothes, style, skin colour, gait, body size and shape and voice. Seeing a person in their expected context, too, can be a great help – the reverse can be extremely testing and, for many, anxiety-provoking.
We will all, at some time or other, have had that experience of not immediately recognising a person out of context. This is of an entirely different calibre to the experience of someone with face blindness, though it might give us the most basic insight into what it must be like to live with this difficulty. Life can, indeed, be a relentless daily social struggle.
Recognising and knowing
There is an important distinction, however, to be made between recognising and knowing. Dr Ashok Jansari, senior lecturer in cognitive neuropsychology at Goldsmiths, University of London, clarifies, ‘It is not that people with prosopagnosia have lost their ability to know who people are – it is just that they cannot know or recognise them by their face. They will use what we call “personal knowledge” – the person’s clothes, what they do, how they sound, and so on.’
Prosopagnosia, then, is not a condition involving the failure to know somebody, it is just the knowing won’t happen through seeing the person’s face but by using other criteria.
Dr Jansari continues, ‘Most people won’t know they are face blind until they are an adult. Even then, some will never know but just know that they are a bit different to others in terms of recognising other people. Others will accept that they have this difficulty that they’re just not very good at recognising people.’
He says there is no conclusive evidence that facial-recognition training or rehabilitation is successful, though research continues. The condition is not, as such, treatable
It is clear that face blindness is a condition that does not affect only a small community of people. It is likely that on a day-to-day basis we encounter young children and, indeed, parents, members of staff and visitors who live with this condition.
Misunderstood
Because it is a disorder that is so little known, those who have it can be on the receiving end of prejudice. People may jump to false conclusions about them: they are seen as unfriendly, rude, a bit odd, aloof. Children can be thought of as being disobedient or rebellious if they don’t immediately go and work with, play with or sit next to a child they have been asked to be with.
Face Blind UK (FBUK) is an organisation working with schools and colleges – invariably, those they work with are surprised about the existence of the condition. FBUK director Jo Livingston says, ‘The danger then is that the signs of face blindness may be mistakenly understood to suggest that a child has an autistic spectrum disorder or ADHD, because it can happen that special needs teachers and nursery teachers are very keen to be helpful when they see there is a problem, but they cannot recognise something they’ve never heard of.’
Signs of face blindness
FBUK aims to raise awareness of the main ways in which being face blind manifests itself in young children, principally:
- Having difficulty making friends.
- Experiencing anxiety and stress in social situations.
- Avoiding using names and making eye contact.
- Having difficulty following the characters in a film or story.
- Appearing inattentive or easily distractible.
What is complex about prosopagnosia is that any of these difficulties can have other causes, and it is not easy to diagnose a young child with prosopagnosia.
Strategies for helping face-blind children
What is important is that practitioners become generally aware of the condition and think about strategies that might be helpful to face-blind children. Much of our ‘ordinary’ practice, for example, when we mix up groups of children, might be very disorienting to a child who has difficulties recognising faces. Similarly, children are commonly expected to know where to hang their coat and bag because their photograph is displayed by their peg – letting all the children add another symbol of their choice will help the child who is face blind and who might not recognise their own picture.
On trips, a child with face blindness can be especially vulnerable – it can help if the adults wear something distinctive that the child can use as a visual cue.
Practitioners and parents can also help by modelling a range of devices that we use to recognise people. This can develop and reinforce those that the children already use to distinguish others.
A HIDDEN DISABILITY
Face blindness is a hidden disability. As there is no known effective treatment, practitioners would do well simply to bear the condition in mind and to have arrangements in place to support children who are face blind as part of their ordinary inclusive practice. Shouldn’t we take care to avoid jumping to conclusions that children are anti-social, disorientated, defiant or suffering from extreme anxiety before considering that they may simply not be able to recognise people’s faces?
MORE INFORMATION
Caroline Vollans is a teacher, psychoanalyst and author of Wise Words: How Susan Isaacs Changed Parenting
