Imagine looking at a friend’s face, and part or all of their features begin to distort, instantly or gradually. Their eyes are sunken, lips bulbous, and skin melting. That’s the reality for people with prosopometamorphopsia (PMO), a rare disorder that affects the brain, turning in-person conversations into terrifying experiences. Freelance science reporter Shayla Love recently wrote about this for the New Yorker.
She tells KCRW that for one of the people she met, Jason, it takes a few seconds for the distortion to happen, affecting half of the person’s face. “There'll be a sunken area around the eye, the mouth will stretch out … and then the canine tooth on the right side will start to elongate.”
Another man in her story, Victor, saw distortion immediately, affecting the entire face. “Both sides of the mouth will start to stretch out and expand, and the eyes will do the same thing. And then there'll be three lines on the top of the forehead where the forehead is getting stretched out. So it's quite dramatic, and sources independently use the word demonic with me … to describe what the experience is like to see faces this way.”
The faces mostly stay this way too. She says Jason is a special case where he can “reset a face” if he looks away, but it distorts when he looks at it again. For Victor, the faces are always morphed.
However, she points out, “[Victor] has a very special quality to his PMO, where he only sees the distortions on three-dimensional faces. So if he looks at screens, for instance, he doesn't see the distortions on … television or looking at a cell phone. … There are these subtle variations between PMO patients that we don't really understand why.”
Love emphasizes that PMO is more consequential than face blindness, in which people are born without the ability to recognize others’ faces, even those of their friends and family. Prosopagnosia creates some disconnect between the viewer and their subject, but prosopometamorphopsia completely cuts off the ability to read other people’s moods and actions — whether they’re distracted, bored, hungry, listening to us or tuning us out, etc. — and replaces those signals with distress.
Jason and Victor weren’t born with PMO, but developed it later in their lives. “In Jason's case, he had a really severe case of mono that he had a really high fever, and he was sick in bed for many weeks, and he developed the distortions after that. … Victor's case, it's harder to pinpoint the cause, but he had a head injury that gave him a pretty severe concussion, and he also had carbon monoxide exposure at one point. So most of the cases that we know about so far happen after some kind of brain injury.”
Researchers are now investigating whether congenital cases exist (meaning whether people are born this way), and whether you can alleviate the symptoms.
She points to one peculiarity: “Certain colors seem to make the distortions better or worse in some people, but the colors are not consistent, and it doesn't work for everyone. But Victor, for instance, the distortions go down a lot when he looks through a green filter. And so they are testing right now if green or red or blue can help other people's distortions. But that research is ongoing at the moment.”
She adds, “Victor has this pair of green glasses that were made for him, and they can help reduce the distortions. But I think he has had to basically just deal with it. He has a job that doesn't put him in contact with people all the time. He was working in a kitchen. He's not working in a kitchen anymore, but at some point he just had to adjust to it.”
So far, PMO has given scientists some revelations about the brain. One is that facial perception differs from facial recognition. Also, the brain is likely piecing together the left and right sides of a face.
“Jason has hemi-PMO, which means that the distortions only affect half of the face, and this is very common. … I found this interesting because you don't think of your lips as being two parts. Your lips just feel like one thing. But actually there's probably a line going down your face where your brain is doing each side individually. … It teaches us how we put faces together, all of us every day, even if we don't have PMO,” she explains.
Love shares her personal takeaway from this reporting: “There is no such thing as faces as they are. Perception is a really active process that we do, so we are constructing all the faces around us. And so it was just a really interesting window into the fact that faces are more subjective than you think.”