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January 4th, 2011
09:47 AM ET

Human Factor: Faces never familiar to famed doctor

In the Human Factor, Dr. Sanjay Gupta introduces you to survivors who have overcome tremendous odds. Confronting a life obstacle – injury, illness or other hardship – they tapped their inner strength and found resilience they didn’t know they possessed. Be inspired by their successes, as we have been. Today, renowned neurologist and author Oliver Sacks explains how he has coped with the rare but real disorder known as face blindness.

I have had difficulty recognizing faces for as long as I can remember. My inability to recognize schoolmates would cause embarrassment and sometimes offense— it did not occur to them (or to me, for that matter) that I had a perceptual problem. I recognized close friends without much problem, but this was partly because I identified particular features: Eric had heavy eyebrows and thick spectacles, and Jonathan was tall and gangly, with a mop of red hair.

I had no trouble recognizing my parents or my brothers, though I was less adept with my huge extended family and completely lost trying to identify them in family photos.

But I still sometimes fail to recognize my assistant, who has worked with me for  27  years. I have what neurologists call prosopagnosia—an inability to recognize individual faces as most people can.

I sometimes don’t even recognize myself. Thus I have often apologized for almost bumping into a large bearded man, only to realize that the large bearded man is myself in a mirror. One day, sitting at a sidewalk café table, I turned to the restaurant window and began grooming my beard, as I sometimes do. I then realized that what I had taken to be my reflection was not grooming himself but looking at me oddly. There was a gray-bearded man on the other side of the window, who must have been wondering why I was preening myself in front of him.

Although such examples may seem comical, they can be quite devastating. People with very severe prosopagnosia may be unable to recognize their spouse, or to pick out their own child in a group of others. Anne F., a correspondent of mine with a lifelong prosopagnosia, notes that her father and sister both have the same condition: Her father, she writes, “was unable to recognize his wife in a recent photograph [and] at a wedding reception he asked a stranger to identify the man sitting next to his daughter”–her husband of five years at the time.

We prosopagnosics need to be resourceful and inventive, to find ways of circumventing our deficits. We may become expert at recognizing people by an unusual nose or beard, spectacles, or a certain sort of clothing. Sometimes we recognize people by voice, posture, or gait; and, of course, context and expectation are paramount—one expects to see one’s students at school, one’s colleagues at the office, and so on. Such strategies, both conscious and unconscious, become automatic.

Nonetheless, I tend to avoid conferences, parties, and large gatherings as much as I can, knowing that they will lead to anxiety and embarrassing situations—not only failing to recognize people I know well, but greeting strangers as old friends.

Face-blindness affects a small but significant minority of the population—2 to 3%, perhaps 6 or 8 million in the U.S.  alone. And at the other end of the spectrum, there are another 2 or 3 percent, super-recognizers who may instantly recognize the face of a waitress or bus driver seen only briefly years before.

Harvard psychologist Ken Nakayama and other researchers have been working on finding the neurological basis for this wide range of abilities to recognize faces, as well as the social consequences of face-blindness (more information on their work is available at www.prosopagnosia.org).  For myself, I find it a relief to go public with my prosopagnosia—and know that I am not the only one.

Human Factor appears on "SGMD," 7:30 a.m. Saturday-Sunday

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Filed under: Brain • Human Factor

soundoff (142 Responses)
  1. Som

    ............. except of course my last message... which got through but I forgot I hadn't hit "reply". This CNN commenting system is super unrefined. Works great for simple messages, but gives you no feedback as to why a message was filtered out. Feels like it was written by some kid interning for their CS degree. Oh well.

    January 4, 2011 at 16:29 | Report abuse | Reply
  2. M

    Wow, fascinating stuff though I am sorry for the people who have to deal with it on an everyday basis. Just out of curiosity, when you say you're watching a movie and 'everyone looks alike'—what do they all look like? Is it you see one character and the rest then take on the same features? Or they're all just 'netural' somehow...

    January 4, 2011 at 16:35 | Report abuse | Reply
    • Star

      they're all kindof grouped into types, by certain features – color and style of their hair, body type (height, weight, etc), but if too many features are similar, then the characters get confused, as someone earlier posted an example in 12 Angry Men – all with short-cropped, dark, hair in similar suits – that's a big problem.

      January 4, 2011 at 16:56 | Report abuse |
    • Bruce

      It's not that movie characters all look alike. In fact, they all look different. It's that every time you see an actor in a new scene, you can not be sure who they are and how they fit into the action until something puts them in context. Example: Every time I saw Merry or Pippin in the Lord of the Rings, I had to wait until another character addressed them by name, or saw the two of them side by side, to be sure which one was which.

      January 4, 2011 at 18:11 | Report abuse |
    • Pat

      Star - I am so happy that you described it that way. That is exactly my problem too. I keep asking my husband who these people are - which one is which? Luckily he has a lot of patience, even if he looks puzzled all the time. He has read this article now, thank goodness.

      January 4, 2011 at 22:16 | Report abuse |
  3. Steve

    I'm glad that I read this, I have the same thing and at times I can not recognize my own wife or children, people come up to me on the street and say hello and I just nod and respond and if my wife is not with me I have no idea who they are.

    January 4, 2011 at 16:35 | Report abuse | Reply
  4. Barry

    I have had this trouble my entire life. Even WORSE, I worked in a lab, and everyone wears the same uniform. At corporate picnics, I would have my wife make certain that she introduces herself FIRST, so that I then know the name of the co-workers. But, if my wife wanders off into the crowd, I cannot find her.

    January 4, 2011 at 16:38 | Report abuse | Reply
  5. Greg

    "Face-blindness affects a small but significant minority of the population—2 to 3%, perhaps 6 or 8 million in the U.S. alone."

    After publishing this article, I have faith that roughly 50 – 60% of CNN.com commentors will claim to ALSO suffer from this condition...and another 15% will claim a close relative has it. Thank you CNN for giving Hypochondriacs something else to claim they suffer from.

    January 4, 2011 at 16:38 | Report abuse | Reply
    • WW

      People who don't have a given condition rarely comment on it. So, naturally, most of the people commenting WILL be the ones who suffer from it.

      January 5, 2011 at 02:06 | Report abuse |
  6. Christopher B. Zachary MD

    This condition is not that uncommon, and is not unlike dyslexia. While this is not a 'disease', it is nevertheless quite disabling for the individual, and should be considered a disability. Like many such conditions, it is expressed variably, some having mild forms, and others, such as Oliver Sacks, having a marked but not absolute expression of the disability.

    January 4, 2011 at 16:40 | Report abuse | Reply
    • Pat

      Right! I could recognize Elvis Presley and Marilyn Monroe, when he couldn't.

      January 4, 2011 at 22:19 | Report abuse |
    • Dr. Buster Bloodvessel

      Are you related to Ed Zachary?

      January 5, 2011 at 12:08 | Report abuse |
  7. ms funk

    I read a book in Afghanistan called 'The Man Who Mistook His Wife for a Hat" by O.Sacks, very interesting

    January 4, 2011 at 16:40 | Report abuse | Reply
    • Dr. Buster Bloodvessel

      It's a great book.

      January 5, 2011 at 12:09 | Report abuse |
  8. Cole

    Way to rip off a New Yorker article from 2 months ago!

    January 4, 2011 at 16:46 | Report abuse | Reply
  9. RichardSRussell

    They say that the upside of Alzheimer's is that you keep meeting the nicest people. I wonder if there's some kind of compensation for this condition as well.

    January 4, 2011 at 16:53 | Report abuse | Reply
  10. Respondez

    Interesting that it seems only to affect face recognition. They don't have a problem distinguishing their comb from their toothbrush, do they?

    I am not being critical here, because I have a bit of this myself, but perhaps some of it stems from an over-concern for the image of oneself that one is projecting to other people - focusing on oneself rather than outwardly.

    My husband was excellent at recognizing faces (he was an extreme extrovert), but I (an introvert and admittedly too self-conscious) don't easily recognize people out of context. I do, however, remember names, dates, addresses and phone numbers, etc. from eons ago. Husband and I made sort of a good pair - he'd say, "That's the guy from so-and-so company... what's his name"?... and I could always retrieve it (including his wife's name, kids and whatever else I knew about him) from my memory bank.

    January 4, 2011 at 16:54 | Report abuse | Reply
    • WW

      I wish it was that easy. I'm an extrovert, though. I don't focus on my self-image; I don't even have much of one. Once I know who someone is, I've got no problems. (if only everyone wore name tags!) But, as I mentioned in another comment, I can't even identify myself in old class pictures. I know I was one of those kids, but I can't point to which one. I've spent all my life trying to learn to identify people's faces - trust me, not being able to do so is crippling in social and business situations - and I still can't.

      January 5, 2011 at 02:11 | Report abuse |
    • AnnJ

      In regards to your question about whether a faceblind person has trouble distinguishing a comb from a toothbrush, the answer is no. And a faceblind person does not have trouble distinguishing a human face from an animal face. A better analogy would be whether you could pick out your own comb from a pile of other combs. If the combs are different colors, it's easy (or if a faceblind person is looking for one blond in a room of brunettes and readheads). If the combs are all the same color but yours is shorter or longer, it is easy (if someone is tall or short). But if all the combs are the same color and the same size, are you sure you can tell which one is yours? That is what faces are to someone who is faceblind.

      January 5, 2011 at 09:44 | Report abuse |
    • Respondez

      I'm really not arguing that my take on it is correct; I'm just exploring possibilities...

      I ascribe my deficiency to lack of attention perhaps due to social anxiety, I guess; but there certainly might be more to it.

      If we have a selection of identical combs, that is one thing; but we are not choosing from a selection of identical people.

      January 5, 2011 at 13:57 | Report abuse |
  11. Bruce

    Mr. Sacks has used the very words I use to describe my situation to others, who have no idea why I've asked for an introduction when I've already met them, or when I fail to recognize a person in a setting that is not the usual one in which I encounter them.

    January 4, 2011 at 17:51 | Report abuse | Reply
  12. George A. Marquart

    I think there have been studies that point to sleep apnea as a possible cause. During apnea episodes the oxygen level in the blood falls, Eventuallly parts of the brain are deprived of enough oxygen to affect their function. The result is the inability to recognize faces and to remember names.

    January 5, 2011 at 00:50 | Report abuse | Reply
    • WW

      I don't have sleep apnea, though, and my blood oxygen remains normal when I'm sleeping (yes, it's been checked). I haven't been able to recognize faces, even family members', as long as I can remember.

      January 5, 2011 at 02:14 | Report abuse |
    • Paganaidd

      Mine is certainly inherited. My mother had it and one brother has it (the Harvard Prosopagnosia study diagnosed me, if you wonder about hypochondria). My grandfather probably had it and my son may have it.

      Distinguishing people is like trying to tell chickens (which I raise) apart. I can generally tell which chickens are the mean ones, the friendly ones etc, because they are my chickens and I see them every day. Other people's chickens? Not so much, unless I am looking for one with a distinguishing characteristic.

      And to try to find one in a whole flock? Really, very difficult. Crowds are the same. Pretty people are especially hard...Pretty people all look the same.

      January 5, 2012 at 11:05 | Report abuse |
  13. Boots

    I'm curious as to what happens when someone with this condition thinks about, for example, his or her spouse? If you are daydreaming about your dinner plans together, can you picture his or her face, a generic face, or otherwise?

    January 5, 2011 at 12:13 | Report abuse | Reply
    • Pat

      No, I cannot visualize his face, only some of his individual facial features, his voice, clothes, etc.

      January 6, 2011 at 12:49 | Report abuse |
    • Paganaidd

      I don't tend to visualize much in my head. I have heard that people think in pictures, but I never have. I think in words, feelings, sound or tactile impressions. If I try hard to picture my husband or my kids, I might picture one feature, but not the whole.

      January 5, 2012 at 11:13 | Report abuse |
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