Brad Pitt has trouble recognizing faces. If you do, too, this might be why

Dr. Jeff Hersh
·3 min read
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Q: Is the condition that Brad Pitt has, where he cannot recognize faces, a real medical thing?

A: We have all met someone who says either “I never forget a face” or “I’m not so good with faces.” Although not every colloquialism like these has a real medical explanation, these possibly do!

It turns out the brain works pretty hard, involving a number of different interconnected processes and areas of the brain (mostly on the right side of the brain but with functional MRI showing areas in the left hemisphere are also involved), to identify and recognize faces. Prosopagnosia (a fancy medical word often casually referred to as "facial blindness") is a condition where someone has limitations, to whatever degree, in recognizing faces. Prosopagnosia is an example of an "agnosia," a class of conditions where someone has difficulty interpreting information from one or more of their senses (hearing, taste, smell, touch or visual).

In a recent interview, Brad Pitt said he has a condition called prosopagnosia, where he has difficulty recognizing faces. Here he poses during a photocall, July 19, 2022, on the occasion of the German premiere of the feature film "Bullet Train" on a terrace of the Academy of Arts at the Brandenburg Gate in Berlin. Germany.
In a recent interview, Brad Pitt said he has a condition called prosopagnosia, where he has difficulty recognizing faces. Here he poses during a photocall, July 19, 2022, on the occasion of the German premiere of the feature film "Bullet Train" on a terrace of the Academy of Arts at the Brandenburg Gate in Berlin. Germany.

The degree of facial recognition limitation for prosopagnosia patients is very variable; for example, some people may only have difficulty interpreting facial expressions (apperceptive prosopagnosia) whereas others may have trouble even recognizing someone they know well (associative prosopagnosia).

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Prosopagnosia can be a congenital condition (someone is born with it), an acquired condition (as a consequence of brain damage from a stroke, Alzheimer’s disease or other dementias, brain tumors, toxin exposure or other causes) or may just develop over time for unknown reasons (developmental prosopagnosia).

Overall, prosopagnosia is pretty common, with some data noting it may affect as many as 1 in 50 people, at least to some extent! However, because of the variability in exactly what affect it has in an individual person, and the challenges in making a firm diagnosis, the exact prevalence of prosopagnosia is not accurately known.

Prosopagnosia is diagnosed based on the patient’s history, including their subjective experiences. Parents may suspect it if their child fails to recognize people they should know, especially when they bump into them unexpectedly (for example losing the associative clue that “Aunt Jan is visiting”), get nervous in public settings, have trouble socially at school or in other situations, wait for someone to wave at them when they are meeting a friend, have difficulty keeping track of the characters in a movie or TV show, etc. Patients may notice it because they seem to commonly confuse one person for a different person (even if these people do not actually look a lot alike), or simply note that they often do not recognize someone they feel they should.

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Although there is no specific test for prosopagnosia, evaluation by a clinician (for example using the Cambridge Face Memory Test or other tool), including examining the patient’s interpretation capability for other sensory signals, may be done. Imaging (for example an MRI or CT) may be done to evaluate for the possibility of one of the conditions that can lead to acquired prosopagnosia (as noted above).  In some cases other testing may be indicated.

Not only can prosopagnosia directly cause issues with social interactions, but it may lead to a more generalized anxiety, especially in certain social situations. Similarly, it may affect work and/or social relationships, and/or may have other psychosocial affects.

Prosopagnosia is usually a permanent condition. The only direct treatment for prosopagnosia is to treat possible underlying conditions (see above) that may be causing it. However, people affected by this condition can learn coping skills and enhance other perceptual skills to help them recognize people (for example learning to recognize other identifying features in people such as hairstyle, voice, gait, others).

If you have trouble recognizing people’s faces, especially if this is severe or is new/progressing, you should speak with your health care provider. Prosopagnosia is common, and in some cases it may be a clue to developing some other underlying condition.

Jeff Hersh, Ph.D., M.D., can be reached at DrHersh@juno.com.

This article originally appeared on MetroWest Daily News: Prosopagnosia condition makes it hard to recognize people's faces