The face of the murderer: Prosopagnosia

“The face is the barcode of the human race. Since man became tribal we constantly see the faces of others trying to decide if they are friends, enemies or lovers”

Dr. Laugenkamp from the film The face of the murderer

Can you imagine that when you get up one morning you look at your partner's face and you can't recognize him. That when walking down the street your best friend greets you and even staring at him you can't identify his face. Why does this happen? What do I do to live day to day with this condition? With this article we will be answering these questions by addressing this strange disease called prosopagnosia . We will delve into its characteristics and treatment starting from the analysis of a case extracted, of course, from the Seventh Art, because what better way to learn than through the pleasure that good cinema generates. Say no more, let's start by describing our case today.

Case

Faces in the crowd or The face of the murderer is a 2011 film directed by Julien Magnat that, although it is not a recognized cinematographic work, manages to capture the attention of the viewer by reflecting for 98 minutes the life of Anna Marchant ( Milla Jovovich ), a young school teacher who, after witnessing the crime of one of the most wanted serial killers in those days, tries to flee and in the escape falls into the sea, thus hitting her head. Upon awakening a drastic turn gives Anna's life; she is unable to recognize the face of her boyfriend, friends, and even her own in the mirror, which is why she is diagnosed with prosopagnosia.

What is prosopagnosia?

To give answers to what prosopagnosia is, we must begin by briefly addressing the structure of our brain, because clearly all our actions and way of being come from it. But don't worry, it will be worth it, this will give us an explanation of why Anna Marchant can't even identify herself in front of the mirror.

As we know our brain is divided into two hemispheres: right and left, which are formed by lobes that are named in the same way as the bones of the skull, hence they exist:

• Parietal lobe: function of receiving information from the senses.

• Frontal lobe: voluntary motor function, it is in charge of our moods. So now you know who to blame if your partner woke up a fight.

• Temporal lobe: functions associated with smell, hearing and memory.

• Occipital lobe: function related to vision and therefore the perception of color, movement, direction.

Visual agnosia as a deficit in the recognition and association of faces is caused by damage to the occipital and temporal lobes, associated as we have seen here with the reception of visual stimuli and how these are stored in our memory, to later access this information and recognize in a crowd , for example, who is a familiar face and who is not. This visual alteration to be diagnosed as such should not be attributed to loss of vision, language difficulties or general mental deterioration.

“Every time you look at someone's face it's like you've never seen it before. Even if it's someone close. Even his own reflection”

Doctor from the movie The face of the murderer

There are two types of visual agnosia:

• apperceptive: it constitutes a perceptive deficit as its name indicates that it incapacitates the person to identify faces. What we see damaged here is the perception and mental representation. An example of this affectation would be that when looking at a person they do not know that what they see is a face, they do not have an elaborate concept of what a face is. Strange right?!

• associative: unlike the previous one, there is a perception and mental representation of what a face is, but it is not capable of associating that face that it sees with the identity of the person itself. It cannot associate the face it perceives with the information of faces of people it has in its memory. Which is just as difficult and painful because you have in front of you your partner of years, your mother and that your mind says << No ! This is not it ! It's not who you think it is ! That face is that of a stranger ! >>.

Within this last visual agnosia we find two subtypes:

• Structural associative visual agnosia: difficulty representing the structure and features of what is perceived.

• associative visual agnosia of semantic access: difficulty in associating what is perceived and its function.

Anna Marchant then suffered from structural associative visual agnosia, which is where prosopagnosia comes in. Her ability to perceive faces was intact, however, as she herself expressed in the film "(...) of course I can see people's faces . It's just that they change all the time."

Prosopagnosia comes from the Greek prosopon , which means face, and agnosia , which means absence of knowledge. From the etymology of the word, this inability to identify other people's faces indicates to us, and in more serious cases, he cannot even recognize his own in the reflection of a mirror. Based on the origin of the disease, it indicates two types of prosopagnosia:

• Acquired: is one whose onset is caused by a lesion in the areas of the brain already mentioned. It is the more common of the two types.

For example, Anna led a normal life until she falls in an attempt to flee from the murderer and hits her head, thus damaging the temporal-occipital lobe, causing her perception of faces to be intact when she awakens, but she cannot associate them with that representation that has in his memory of his partner.

• evolutionary or developed: it is rarer to find and only a small percentage of the population has it, however it exists and consists of a type of congenital prosopagnosia where the person who suffers from it never manages to develop the ability to identify faces. He has difficulty perceiving them throughout his life without being in the presence of a known neurological lesion as in Anna's case.

“Face blindness is not something you contract. It is something that is lost. She will have to get used to people changing their faces as soon as they stop seeing her”

Dr. Laugenkamp from the movie The Face of the Killer

What diagnostic tests can be used to diagnose this disease?

In the film we see that the Doctor uses a technique to diagnose the disease in Anna, and it consists of showing her photos of the same person so that the patient can identify if it is the same face or not, this test is called Pairing of identical photographs. There are other procedures that can be used such as:

• perceptual face identification test

• drawing of a face

• copy of drawing of a face

• visual or verbal matching

• facial expression identification test

• face memorization

Is there any treatment for people with prosopagnosia?

Much work is still being done in the search for a treatment itself for these patients, however therapies focused on recognizing people by their voice, way of walking, or some characteristic feature such as a mole, scar or beard (such as the case of the film) that help to associate those unique characteristics to each individual and to be able to continue their social life. This treatment is known as compensatory strategy training and is the most used in cases of visual blindness , it has the objective of developing skills so that they can identify others through these traits. Neuropsychological rehabilitation can also be carried out as another way of treatment, although it is the least used.

If you liked it or have any suggestions on a topic of interest to you, let me know here in the comments so we can delve deeper into the world of cinema and psychology.