Writing characters with: prosopagnosia

“We’re blind to our blindness. We have very little idea of how little we know. We’re not designed to know how little we know.”

- Daniel Kahneman

—> I have never heard of prosopagnosia. What on earth are you talking about?

Prosopagnosia is a rare neurological disorder that results in being unable to recognise human faces.

You know how you look at someone and know instantly who they are? You can look at your friend and say ‘that’s Kelly’, without having to think about it. You don’t need to consciously work it out inside your head like you’re solving a math problem. You just look at your face in the mirror and go ‘yep, that’s me!’

People with prosopagnosia are not able to do that. To them, every face is a stranger’s face — even their own reflection.

—> Why should I listen to you about prosopagnosia?

I have done so much research on this, both out of general curiosity and specifically for a character I’m writing. I’ve seen firsthand accounts from people who acquired prosopagnosia in the wake of traumatic brain injury. I’ve seen what it looks like from the outside, and I’ve heard about lived experiences from the inside.

—> Okay, so what is prosopagnosia?

You might have heard it described as ‘face-blindness’. That’s a bit of a misnomer, because people with prosopagnosia do see human faces. They don’t live in a world of faceless monsters like an episode straight out of Doctor Who. They can usually differentiate between different human faces as well. The difficulty is in recognising human faces, which usually occurs because of damage to the area of the brain that deals solely and specifically in facial recognition.

There’s an area of the brain — specifically the fusiform gyrus — that takes all of the individual facial elements we see in a single human face, combines them, processes them, and connects them with a previous facial memory, nearly instantaneously. When this process works like it should, we have no idea it even exists. Our individual experience doesn’t leave us with the idea that we only see parts of a human face. We just see our friend’s face and immediately know that’s our friend’s face.

When you have prosopagnosia, however, there’s a breakdown in the processing and connection of previous stored facial memories. The result is that you’ll look at your friend’s face, and… you’ll just see a random human face. A stranger’s face. You might intellectually know it’s your friend, because they’ve said it’s them, or because you recognise their voice or their hair. But your fusiform gyrus will insist that, okay, sure, it’s your friend, but that face is not your friend’s face, okay.

Here are some things to keep in mind:

• Prosopagnosia does not mean you become paranoid. It’s a disability in sensory and perception, not in cognition. That means you may not recognise faces, but you know you don’t recognise faces, and so you learn to rely on other cues like voice/hair/clothes to recognise someone in a crowd. You won’t suddenly believe you’re alone in a sea of strangers, or that your parents are lying about being your parents.

• Prosopagnosia is often present from birth. In fact, a lot of people who have milder forms of prosopagnosia never even realise it; they’ll often laugh it off as ‘being bad with faces’. People with autism, especially well-masked autism, can have prosopagnosia without knowing it too. There are a variety of effects, including being unable to judge someone’s age or gender, or not being able to read someone’s emotions. (Have you ever met someone utterly oblivious to when you were angry with them, even though you kept dropping what you believed were obvious hints?)

• It might help to think of prosopagnosia not as blindness, but as a blind spot. I’ve seen the feeling described as a little like working with a group of monkeys, and needing to learn how to recognise a single monkey quickly. Without training and practice, you can’t do it. You have no brain circuitry for storing or processing facial memories when it comes to monkeys. So you learn to tell them apart using other cues, like colour, size, weight, or shape. The difference of course is that with other animals, we can train ourselves into recognising their faces quickly. With prosopagnosia, training ourselves out of it usually isn’t possible. Instead, we’ll learn to mask it really well — or, in other words, we learn to hide it from the world by compensating using other methods.

• Prosopagnosia has absolutely nothing whatsoever to do with psychopathy or sociopathy. It does not change your ability to empathise with others. It does not change your worldview or your personality. It can be difficult to imagine for those of us who have never had any difficulty with recognising faces, and sometimes that difficulty makes us think that a lot more must be wrong as well; but the affected area of the brain is only involved in processing faces.

• Prosopagnosia can also be a spectrum. The most acute and obvious cases are primarily caused by traumatic brain injury, meaning the person had no trouble recognising faces until an accident occurred that ruined their ability to do so. But prosopagnosia in milder forms can be a symptom of other conditions present from birth as well, like autism. It isn’t usually called prosopagnosia unless it can’t be explained or connected with anything else, but just be aware that a lot more people have genuine trouble processing faces than you might realise.

—> Have you written any characters with prosopagnosia? How did you do it?

Yes! I’m currently writing a character with prosopagnosia. In the setting of the story, neural implants to compensate for abnormalities in brain development are common, so the character in question had absolutely no idea — not until a near-death experience that required all his implants to be removed.

Because the accident was a traumatic near-death experience, I write him reacting dramatically at first, since as far as he’s concerned, he died, then came back, and now no one he knows is there. It takes a while to calm him down and convince him that’s all in his head — much longer than I would normally consider believable, but only because of the surrounding circumstances. (I talk a lot about how every single aspect of mental health can look completely different in different people, and how you should never consider your character to be in a diagnostic vacuum. This is a perfect example. People are people, not lists of symptoms, and artistic license is important!)

In the aftermath of that initial reaction, all of the other characters come up with really creative ways to help him adjust, ranging from ridiculous hairstyles to tattoos and scarves. With all that social support, it doesn’t take my character very long to reach a new equilibrium and act like nothing ever changed at all.

—> So what tips do you have for writing prosopagnosia?

If you’ve never played the game Nine Hours, Nine Persons, Nine Doors (affectionately called 999), I highly recommend it. Without going into too much spoilery detail, one of the characters has prosopagnosia, and it’s one of the most accurate depictions I’ve seen in any media ever. Disclaimer that this character also has an unrelated set of [spoiler!] circumstances that make them a right royal asshole and that this has nothing whatsoever to do with prosopagnosia; in their case, I would call prosopagnosia the motivation for their actions, but definitely not the cause of their actions.

—> Any other things I should keep in mind for my character?

Throw out the diagnostic vacuum. If you’re writing a character who has prosopagnosia, you’ll need to decide how that slots in with everything else about who your character is. Decide whether it’s the result of injury or birth. If it’s injury, then chances are your character is dealing with a lot of other things as well, and how each of those things impact on them might be wildly different. If it’s birth, then:

• Does your character know they have prosopagnosia?

• Do they have techniques and methods for compensating? Are they aware they compensate at all? Could they explain what they’re doing if someone asks?

• Would your character be different if they grew up without prosopagnosia? How different? Is it a difficulty that barely registers, or is it more prominent in your character’s thoughts than they think?

For further reading from people with prosopagnosia, check out this article written by a neurologist with prosopagnosia, as well as an interview with a face-blind artist who has found an extremely creative workaround involving two-dimensional paintings.

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