Getting Diagnosed (Tested) for Face Blindness
I believe one should stay away from doctors unless there is something they can do for you. That said, here are my comments on the prospects of diagnosis, and possible treatment to follow it.
Reasons To Get Diagnosed - Or Not To
"Diagnosis" is of course the process by which you get a medical professional to give you a piece of paper stating that you have a condition. These are the reasons one might want to be diagnosed for a condition, whether it be face blindness or anything else:
- For treatment.
- To become eligible for services.
- To become entitled to an accommodation.
- To better know yourself.
- For peace of mind.
Now let's look at each of these in turn as they apply to face blindness:
There is no physical treatment for face blindness. It's caused by a miswiring in the brain. You wouldn't want someone cutting away at your mind with a knife, anyway, now would you? Besides, at this point in time, no one would be sure where to cut, or what to do once they went to work there.
This means the only thing you can do about your face blindness is to accept it. If you need counseling help to do that, then that could be said to be a form of "treatment." When it comes to face blindness, counseling is the only treatment you'll get. But don't get too excited just yet. There is more to be said....
If you go the counseling route, be aware that there is virtually nobody out there who knows anything about what it is like to live with this condition. Sadly, almost all involvement of the medical community has been with the physical aspects of face blindness, for which there is no treatment, rather than with the psychological aspects, for which there might be. So before proceeding, you might ask any prospective counselor two questions:
When seeking help to cope with my hearing impairment, I found the only useful information came from people who answered the questions (reworded to say "hearing impairment"), respectively, "Yes" and "100 percent." The others were all very well-intentioned and all very near-to-worthless. They were blind to everyday really basic stuff that every informed hearing impaired person would know.
- Are you face blind yourself?
- What percent of your practice is devoted to helping face blind people?
As an example, a common blunder of such folk is to assume someone does not have a hearing impairment because they can communicate just fine in a quiet soundproof carpeted office where there is only one other person present (the doctor), and that person is intent on communicating with the patient. Any hearing impaired person can tell you that every one of those details are ideal for communicating, and that they seldom appear together in the real world. Evaluating someone's communications skills in such an environment is like giving someone an eye test with two foot high letters. You don't want someone similarly dense to the realities of face blindness playing the role of sage to you.
You may find someone who is a good counselor and who could be of some help to you if they were to educate themselves about face blindness first. If you find someone who is actually willing to do that, refer them to these pages, or to something of a similar bent written by a professional if you can find it (as of mid-2006, you won't).
To sum it up, there is no physical treatment for face blindness, and you'll probably find no counseling treatment of value either. So forget "treatment" as a reason to get a diagnosis. There is no treatment.
Note (added in 2014): Another possibility one could call consider a form of treatment, being investigated as of 2014, is "training", which is repeatedly being exposed to a visual regimen of images designed to make your facial recognition better. This article lays out the status of attempts at training as they exist in 2014. (In the article, "DP" refers to people who were born with face blindness, and "AP" refers to people who got it later.) In summary, work is being done in this area, and partial success has been had with some people. In those cases, the training regimens have been long, they have not always meant success outside the lab, and without continual training, the effects have often faded within a few months' time.
By services, I mean gaining eligibility for government assistance in the form of cash, training, equipment, or treatment. To my knowledge, there are no such services available to people who only have face blindness. It doesn't prevent you from doing all work, which is what is required as a rule to get disability payments, for example. Other conditions you have may make you disabled enough that you are eligible, or your face blindness combined with these other things may make you eligible. The California Department of Rehabilitation considered my face blindness along with my hearing impairment to classify me as more disabled than I would have been with the hearing impairment alone. And The Veteran's Administration will consider face blindness as part of Traumatic Brain Injury (TBI) if its acquisition was service related. If situations such as these apply to you, you may wish to obtain a diagnosis for face blindness to accompany and bolster the other diagnoses you have. Otherwise, forget "services" as a reason to get a diagnosis.
Accommodations are things like wheelchair ramps and teletypewriters for the deaf. If not unreasonably expensive, these things are required in some locales of employers, schools, and merchants, if providing them will make it possible for a disabled person to participate who couldn't have otherwise.
As a face blind person, your main problem comes not from physical barriers but rather from the behavior of other people. How individuals look or dress, how they treat you because of how you look or dress, and how they react when you don't remember them or emotionally react to them are things largely out of your control and the control of management as well.
Getting whatever accommodations you can from individuals is mainly a matter of how successful you are with each one at diplomacy. The best you can do is "come out," explain your needs, and hope for the best. Individuals do not as a rule care to see your diagnosis. Instead, from individuals, you will generally get accommodations if they like you, and you will not get them if they don't. So forget "accommodations" as a reason to get a diagnosis. Work on being liked instead.
You can attempt to legally force someone to accommodate you (and if you go this route you would need a written diagnosis), but most of the accommodations you need are of a social nature, and in this area force doesn't generally work to give satisfactory results. (Read this, you will be miserable there and you will soon quit.) If your efforts get you transferred to another department or school, where you're surrounded by different people, then they may have been worthwhile. Of course, it is a lot easier to simply apply for a transfer if that is possible, than it is to go through a court process. And don't overlook just going somewhere else if avenues are open. That is sometimes the best solution of all. If avenues are closed, though, you may have no alternative but to fight.
To Better Know Yourself
This is a new reason we added in 2002. Cutting edge researchers had by then encountered enough face blind people that they knew of different weaknesses in one's visual system they may find along with your face blindness. How are you with objects other than faces? How are you with reading facial emotions? Are there some facial emotions you read better than others? An individual testing you may find answers to these questions that surprise you, and knowing of them may help you navigate a little better through life.
A full neurological assessment may also reveal other deficits. Face blindness, like most neurological deficits, often does not appear as your only one. Full neurological assessments usually don't include anything more than a brief face recognition test for face blindness and those giving the test may give you an outdated one (see below). Neurological assessments are for where you feel you have other major issues, and these assessments are usually very expensive. They are not the best route to learning about your face blindness but their existence should at least be mentioned here.
All this "know yourself" information will reveal nothing for which there is medical treatment, so your medical insurance is not likely to pay for it, unless it's recognized for its value as an adjunct to counseling. Indeed, the information it will provide will be more akin to what you'd find out from tests that help you decide on a career (though those tests will not give you this information). Just keep in mind what I've said above about the likely ineffectiveness of counseling if you are considering that route.
Peace of Mind
Having ruled out treatment, services, and accommodations as likely reasons to seek a diagnosis, we are left with better knowing yourself, just discussed, and one other motive: Peace of mind. If you want to delve into nuances or you think a piece of paper will make you feel better, and you don't mind the expense, then go for it! In the paragraphs below, I'll discuss what you'll probably find.
Tests for Face Blindness
When I first penned this section in early 1997, I reported there were no reliable tests for face blindness. Happily, we can now in 2006 report that has changed. The old unreliable tests are still floating around though, so a discussion of them is warranted. I will discuss the various tests now available:
- Traditional booklet tests with photographs
- Celebrity tests
- Recent tests on a computer
- Brain scans
Traditional Booklet Tests with Photographs
These older tests will have you looking at pages in a booklet that contain photographs of people's faces. One of the most popular, the "Benton" test, will show you one face along with six more. You will be asked to point out which of those six is the same person as the first. Some questions will show the faces all facing forwards. Others will have them turned at different angles, or with light falling on the faces from different directions. Another common test, the "Warrington", will show you faces which you have to recognize on later pages in the booklet.
Seldom will these face blindness tests include people with mustaches or beards, and in some tests the hairlines are masked as well. The tests will not show the bodies of people - just heads.
You should know that there are some problems with these tests, and you may encounter some problems with the people who administer them as well.
Problems with the Tests
The biggest problem is that these tests reveal how well someone does with the task of comparing faces in the present, rather than testing how well one stores a facial image and is able to recognize it in the future. One's skills at these two tasks may not necessarily correlate. While the tests evaluate your skills at matching faces, almost all requirements you encounter in your daily life require you to remember them. Perhaps the tests would give more realistic results if a time period of an hour, or a day, were to intervene between the viewing of the first face and the ones to which it is to be matched.
After considerable thought, I can only come up with one situation in society where one ever encounters the need for a skill in matching faces, and that is if you are someone checking ID pictures. Oh, and you might have a need for this skill if you see a bank robber behind you in line at the post office - not exactly an everyday occurrence. On the other hand, we have a need to remember faces all the time.
Test scores of face blind people will vary widely on a particular test. Researchers believe this is because the wiring glitches behind each person's face blindness are different. Just because a person does better with the narrow skills demanded by a particular test, though, does not mean he will do better bringing to bear the wider range of skills that are needed to recognize faces in social settings.
Another problem with the tests is that most of them have not been tested on a large enough sample of people - both those with and without face blindness - to reliably report to test administrators what kind of results they should expect.
One researcher (Brad Duchaine, who will be discussed further below), removed almost all facial data from the images of both the Benton and the Warrington tests, to the point the images did not look like faces. His controls still completed the tests with scores in or just outside the normal range. Thus the tests do not test special skills with faces to an appreciable degree. These tests were for years among the most widely distributed, so watch out! Not taking too seriously any diagnosis based on them is wise.
Problems with Test Administrators
Some test administrators who still use these older tests realize that the tests they have are testing for matching skills rather than remembering skills, and that some people who are face blind will nevertheless do well on some tests. These administrators may also know that they don't have much solid research backing whatever guidance they have in interpreting scores on the tests. Having this knowledge will enable them to realize that the tests have limitations, and they will weigh the test results along with your reported life experiences in order to make a determination. Other administrators will doggedly adhere to the numbers they extract from their test, and you may get misdiagnosed as a result.
Another problem with administrators is that some do not realize that there is a great difference in the speed at which people with and without face blindness accomplish facial recognition tasks. Face blind people may require eight seconds to reach an answer that would come to someone without face blindness in under one second. If they give a test to two people, one of whom is face blind, their test results might not be that much different if the people being tested are given as much time as they need. With a short time limit, their scores might differ greatly.
The importance of the time limit must not be overlooked, because it parallels what we encounter in real life. Since most people recognize a face in under one second, that is the time that society allows. Someone who requires eight seconds will, in that interval, have long passed a friend on the street without recognizing him. By the time eight seconds have passed, people coming into your presence who don't know of your face blindness will be offended at your failure to recognize them. And long before you even get your eight seconds, you will be criticized for "staring." Someone who lives with face blindness will know these things. Your test administrator may not.
One of the most telling tests can be a "celebrity test". The face blind person is shown the faces of about twenty-five very well-known people and is asked to state their names. Afterwards, he is given a list of the people's names and for each is asked to identify who that person is, such as "movie star", "Queen of England", etc. People who are not face blind will get almost all, if not all, of both parts of the test correct. A face blind person will identify few of the photos, but nevertheless know who most or all the names are. In my case a celebrity test also revealed the reality that I perform much worse with identifying women than men - the few I got correct were all men.
The celebrity test works so well because it approximates real life - the examinee is expected to recognize individual faces out of thousands he's seen over many years. One advantage to the celebrity test is that there is no critical timing factor for the examiner to observe. When the number of potential answers soars into the thousands, "tedious study" just doesn't get the examinee anywhere, and he even realizes that and relaxes; he either knows the face or he does not. Another advantage is this test can be given with paper and pencil, requiring no computer or other equipment. A disadvantage is that the test must be tweaked for the examinee's locality and generation, and then must first be run on similarly situated controls. This disadvantage overcome, however, the celebrity test soars high above any others when it comes both to giving definitive results and to ease of administration.
Recent Tests on a Computer
Brad Duchaine, who at the time was at the University of California at Santa Barbara, and who now heads a group of researchers working on face blindness at Dartmouth College in New Hampshire, extensively interviewed me and another face blind man about what a face blind person found recognition to really be like. He took that information to develop a test that when scored provided a much wider disparity than traditional tests did, between results for the face blind and others (his "controls"). To approximate real world facial recognition environments as we revealed them to Brad, he found paper and pencil were not up to the task. He found it necessary to construct his test on a computer.
Brad's first test, which has over time been improved upon, strove to approximate the "many faces" environment of real life by requiring identification of 15 photos of one target individual displayed randomly among 150. It also incorporated the time limit reality that exists in social encounters, by having the computer do what testers often fail to do - enforce limited exposure and response times. The computer also recorded response times, and the slower response times of face blind people could be noted when the test was scored. This test was also a memory test rather than a matching test; faces had to be identified a few minutes after they are shown, not at the same time. Face blind people feel tests such as this are the only tests that (1) are reasonably accurate in detecting face blindness, and (2) do not have the cultural and generational problems that celebrity tests can have.
Brad has links to recent computerized tests on line, so if you wish you can try them out right now. One is the test mentioned above, and another is a celebrity test. (Although a celebrity test need not be conducted on a computer, there is nothing wrong with doing so.) For information, you may visit his web site - www.faceblind.org, or you may go directly to the page that lists tests by going here.
Others have been developing face testing on the computer as well in the last few years. They have tended to put the tests on line, rather than going through the complicated process that must precede making them commercially available to counseling professionals or researchers. Some of these tests are quite good, and some are not, depending mainly upon the qualifications of their developers. Take results from tests you may find with an unknown pedigree with a grain of salt.
Researchers are zeroing in on what part of the brain is used to recognize faces, using techniques such as the Functional Magnetic Resonance Imaging (fMRI) scan. By 2001 they had already found out where in the brain most people recognize faces, and they began seeking out face blind people to test. Photos are flashed by the hundreds before the subject much like an old fashioned nickelodeon does, while the researcher's computer records what part of the subject's brain takes an interest in each. In my case, for example, they found the usual "fusiform face area" to be quite inactive when I saw faces.
Face recognition is not yet completely understood, so the scans at this point are not yet considered to constitute the best of tests. Brain scans also cost thousands of dollars, so they don't appear to be in line to be the test of choice in the long run. For now, though, scans can often be had for free because researchers are funded to seek out face blind subjects, and scans indeed can show that you are different (and with a test you'd have no way in hell of influencing the results of).
Looking to the Future
Once someone learns he is face blind, it can take a year or more of deep introspection to discover one's key traits. This is the most useful piece of information one can have in living with face blindness. Some face blind people do not have key traits, so for some this can be a torturous journey to nowhere. Will we soon learn how key traits show up on a functional MRI? Will face blind people show up differently on a functional MRI than other people? Does this mean we will soon have a physical test for face blindness - one not dependent upon any responses - that not only reveals that you are face blind but also reveals what images are your key traits? This is truly exciting.
The latest tests are now at the point where they can say you are face blind or not. They are not yet getting readings accurate enough to evaluate face skills on a continuum as IQ tests do with intelligence. When tests for face skills become that accurate, career counselors will find them useful in directing students into, or away from, careers such as law, management, or sales, which require good face skills. We should then find the administration of such tests to become pervasive.
At that point, a point when segments of the general population are tested for face abilities as they now are for hearing and seeing abilities, we will learn just how prevalent face blindness is. Face blindness will be caught in our youth. Universal testing will mean our floundering for decades not understanding why we have great social difficulties will be a thing of the past.
Researchers - Getting Tested for Free
Face blindness is now a field drawing a lot of interest from researchers. You may find it rewarding to assist a researcher in his work. If you volunteer to help one, you are likely to end up having been tested by the time the research is completed. More information on researchers can be found here.
What To Watch out for If You Take a Test
Most testers you hire will use a booklet test on you, unless you insist on their obtaining a computerized one, so be prepared to be told you are not face blind even though you are. The errors and deficiencies discussed above all lead the evaluator in that direction. If your main purpose in seeking a diagnosis was to achieve peace of mind, you may discover getting this kind of diagnosis was not the best way to achieve it.
The good news is, of course, that the only guy who wants to "see" your peace of mind diagnosis is you. After considering how reliable tests and the ways they are administered are, you may decide your best peace of mind can be achieved by determining whether you are face blind by other means.
If you go about it with diligence - and by that I mean by learning about face blindness first, so you know what to observe - there is no reason you cannot determine your face blindness by yourself. Just like face blindness is, sexual orientation is a neurologically determined condition, and though a written diagnosis can be had for that, few pursue one for sexual orientation. Most people choose to accept theirs based on their own observations.
Getting Your Diagnosis by Yourself
Because most tests given are unreliable, some face blind people have found greater comfort in getting their diagnosis in other ways, such as those discussed below. The more of these ways you use, the more comfortable you will be with the diagnosis you obtain.
One way is to compare how you do against other people around you. Don't knock this method - lots of people discover they need glasses that way! If you are always asking your spouse, "Who was that?" much more than they ask you, that is a clue. If you never know who the various movie, TV, or sports stars are, while everybody else does, that is a clue. If people recognize you much more often than you recognize them, that is a clue.
How you do at following the plots of TV shows is an excellent way to test for face blindness. If you have trouble following the plots of many shows, be very suspect, because you can't follow most plots if you can't tell the actors apart. A hearing deficit can also be to blame for this, and you will want to rule that out as the only cause. Since many face blind people also have a subtle hearing impairment, find a TV with "captions" (subtitles) and turn them on. Watch a few shows with them on until they are no longer a distraction. If you still have trouble with quite a few shows, be very suspect. Most TV shows are fast paced and show little but quick glimpses of people, and when they do show people, they concentrate on the face. Remember, if most people could not follow the plot of a popular TV show, it would not be on the air for long. In effect, TV shows have been normed by the rating services to the general population using thousands of subjects, to a fine-tuned level never attained by anyone who designs "tests".
Another tack is to compare your life experiences with others who are face blind. When you read the words of folks in another land, people whom you have never seen, that correspond precisely with your own life experiences like no words you have ever read before, you will take notice. When this happens over and over, you will know beyond reasonable doubt. When they say things that no one in his wildest imagination could have invented, you will know beyond all doubt.
If you have read these pages and said "Me too!" more than you ever have in your life, you know. If you read them and cried, not for me but for you, you know. You have your diagnosis. May it give you the "peace of mind" that you need to accept it and get on with the rest of your life.
"Face Blind!" - Table of Contents
Chapter 1 Introduction Chapter 2 Discovering Face Blindness Chapter 3 Physical Causes of Face Blindness Chapter 4 The Importance of Recognizing Others Chapter 5 How Most People Recognize Others Chapter 6 Ways To Recognize Others Without Using the Face Chapter 7 How Non-Face Recognition Methods Work in Practice Chapter 8A ...Bill: How I Tell People Apart Chapter 8B ...Pertti: Recognition System - The Essence Model Chapter 9 Effect of Face Blindness on Emotions Chapter 10 Effect of Face Blindness on Sexuality Chapter 11 Effect of Face Blindness on Your Social Groups Chapter 12 Understanding Why People Choose To Look Alike Chapter 13 Ways To Improve Our Lives
Appendix A How To Find Medical Articles on Face Blindness Appendix B Getting Diagnosed (Tested) for Face Blindness - YOU ARE HERE Appendix C Links to Other Face Blind People Appendix D Author's Information Page
This document is copyrighted. For information, or to contact the author, go to Appendix D, the Author's Information Page.
Text of this chapter last revised November 14, 2014.