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Portrait of an Angry Man – or not?

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Portrait of an Angry Man – or not?

The Author

Juliet Roberts

Part of our Emotions and Ethics series, ‘Portrait of an Angry Man’ is written by Juliet Roberts.

Portrait of an Angry Man – or not?

The focus of my presentation for the Webinar on 17 June 2020 was a portrait created in 1918 by the French illustrator, Raphaël Freida. The sitter is Albert V., a French soldier who was severely disfigured in action in Belgium 1915. He was a patient under the care of the orthodontist Albéric Pont, who had established a specialist maxillofacial unit at Lyon in 1914. The middle section of his face was shattered, and along with several fractures of his upper and lower maxillae his nose was torn away. He lost several teeth.

I found this particular image unsettling, since his gaze seems to fix on the viewer, and for some reason I interpret his emotional state as angry. Few of Freida’s portraits have corresponding images in alternative media. However, I was intrigued to find four photographs of Albert V. in Albéric Pont’s albums at the BIU Santé in Paris. This I hoped might resolve my idea that it was an ‘angry man’ in the portrait by Freida, or at least give broader scope to analyse the man and his injuries. With this in mind, I wanted to explore themes of objectivity and tensions between photographic or ‘scientific’ reproduction as opposed to artistic interpretations of clinical images. (Daston & Galison, 1992)

My other concern was that as historians, speculating on the emotional state of an individual may be an overly subjective approach to analysing an image as a primary source.  The following questions came to mind: Is it really possible to decipher the sitter’s emotional state from the images or, in the case of this portrait, are we simply staring at the artist’s own anger? Are the photographs of Albert V. examples of how a ‘mechanical image’ produces a more dispassionate picture of disfigurement and its resolution? Are the words ‘analysis’ and ‘interpretation’ in some way interchangeable? Does their own emotional reaction to and ‘reading into’ an image produce ethical problems for the historian?

Albert V

Using just five colours, Freida’s full-face portrait shapes Albert V.’s features and scarring using multiple, precise strokes, a technique which belies his pre-war profession as an illustrator. The sitter’s eyes and forehead have been spared injury, but the lower section of his face is a gnarled mess of disfigurement. A band of tissue covers the space where his nose was, and there is extensive scarring around his mouth. The viewer is left in no doubt as to how Albert V. received his injuries; he is wearing his military uniform.

Undated, the ‘before’ and ‘after’ photographs show Albert V. with and without a nasal prosthesis. They were part of an album of maxillofacial cases used by Albéric Pont, an orthodontist and prosthetist who established a facial surgery unit at Lyon in 1914. There is more extensive damage visible here, with a large, gaping hole where his nose should be. The corners of his mouth are turned upwards into what appears to be a smile, particularly with the nasal prosthesis in place, and there is a perceptible glint in his eyes (presumably due to light exposure). Somehow, the man in the photograph does not seem to be as troubled as he is in the portrait.

Approaching primary sources

Since subjectivity is such a personal concept, I wondered if any scientific methods had been deployed to measure emotional reactions to art. One study by Leder et al (2014) revealed that ‘challenging’ or controversial art produced more negative reactions from ‘lay’ viewers than ‘art experts’. However, I found this research unsatisfactory as it was based on anticipation of art being a pleasurable experience, or expectation of some kind of mood enhancement; obviously for those who research medical visual culture this is not always possible.

As historians, our approach to primary sources requires us to consider an object beyond its superficial impact. We have to consider how images are manipulated and audiences are targeted. The words ‘interpretation’ and ‘analysis’ produce similar explanations in the Chambers Dictionary (2008); to elucidate, unfold or resolve to arrive at the root cause of something. Consequently, exploring the context in which these images were created allows us to better understand our reactions to them. Certainly, the aim was more than simply recording the injuries for pedagogical purposes.

Portrait and viewer

Freida saw action during the Great War, and was subsequently deployed as an orderly at the military hospital in Lyon. He created a series of portraits of Albéric Pont’s patients and intended to publish a portfolio of these images entitled Les Misères de la Guerre after the war. In view of Freida’s war experience, it is essential to consider the possibility that he absolutely meant to provoke an emotional reaction from the viewer, hence his desire to publicise his portraits of these broken men. As for the photographs, it is clear that behind the recording of Albert V.’s injury and its attempted resolution lay Pont’s desire to promote his work, even if to a limited audience. Accordingly, the photographs were carefully chosen for the album (Mazaleigue-Labaste, 2015).

With regard to the ethical challenges posed by the provocation of emotions, it is reasonable to suggest that it is perfectly acceptable for the viewer, historian or not, to react to and interpret an image in terms of their personal feelings. Whether positive, negative, indifferent, these remain sentient reactions to an image. This portrait is an example of how an image forces the viewer to confront their own emotions, if not that of the sitter and the artist as well.  However, the methodological tools we have as historians allow us step back and take into consideration the broader context of these materials and hopefully reach a satisfactory, balanced conclusion to our inquiry.

Author Bio

Juliet Roberts is a second-year PhD candidate based at the Centre for Contemporary and Digital History at the University of Luxembourg. Her interest lies in artistic representation of facially-wounded soldiers from World War I. Following on from her Master’s research on the theme, her PhD project is entitled Altered Images: A Comparative Study of Medical Portraits by Henry Tonks and Raphaël Freida in the Great War.

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Attentive Looking: Emotions and ethics

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Attentive Looking: Emotions and ethics

The Author

Ludmilla Jordanova

Ludmilla Jordanova

Part of our series resulting from and reflecting on the webinar ‘Emotions and Ethics: the use and abuse of historical images.’ Today’s guest blog is written by Ludmilla Jordanova, who sits on the AboutFace Advisory Board. Here, Ludmilla discusses attentive looking, emotions and ethics in the context of using and researching with historical images.

Attentive Looking: Emotions and ethics

People spend so much of their time looking at faces in one form or another that our minds are chockablock with prejudices and preferences as well as half-formed theories about facial expression and visual habits so ingrained they can scarcely be avowed. The AboutFace project has to grapple with such complexities both as they present themselves in human interactions and in images. The ‘Emotions and Ethics’ workshop in June 2020 addressed the ethics of looking at images that are readily described as ‘difficult’ or ‘sensitive’. In a digital world there are formidably difficult challenges to address since more and more such images from archives are freely available and the thirst for materials relating to medicine, the source of much harrowing material about faces, is seemingly unquenchable. I write this blog as a historian with a long standing interest in medicine, faces, portraiture, visual culture, historiography and the ethics of historical practice.

I am not a generally a big fan of lessons from history, but one we can surely take from the rise of digital media and the near ubiquity of the internet, is the difficulty of exerting control over what is seen and read. There are ethical quandaries aplenty here. The drive to make archival materials openly available has been strong for some time. This is often couched in terms that suggest the opening up of collections is democratising in and of itself, hence the support of governments and funding bodies for massive digitisation programmes. I wrote about these phenomena in the third edition of History in Practice, in the hope that readers would be encouraged to take a critical look at the trend and to reflect on its implications for the ways in which history is taught and researched, including by historians outside the academy.

Hard thinking

The workshop demonstrated the hard thinking that is required when medical images are interpreted and (possibly) published. If large organisations choose to make this form of visual culture freely available, there is very little that scholars can do about it. And this illustrates a major tension – between accessibility and protection – that runs right through our world. We worry about children being exposed to pornography, yet recognise that it is all too easy to find on the internet. Some countries have elaborate laws designed to protect personal data, while those who want to harass public figures can usually find their home addresses.

As historians we are accountable to our employers, our peers, indeed to anyone who reads our published work. There are recognised mechanisms that underpin these relationships, starting with footnotes and bibliographies that make our ‘workings’ clear. Ideally enough is revealed so that claims and approaches can be rigorously evaluated. Professional associations and institutions of higher education address ethical issues through statements and administrative procedures. Transparency is highly valued. We do not expect to be harassed for our views, although historians with a public profile may be engulfed in social media storms. On the one hand there are structured ways in which ethical matters are dealt with, and on the other there is imagery and commentary, which swirl around in a free for all, a situation that resembles the positions in which public figures find themselves.

Historians and historical practice

Historians, however, also have a responsibility to those they study, to historical actors, to dead people who can’t push back on what we say about them, and with whom we experience complicated relationships. It’s vital to avow the emotional dimensions of historical practice, to use the insights we gain through working in a self-aware manner, to inform the handling of ethical dilemmas. Some aspects of these relationships are regulated by laws covering medical records and the naming of patients. The workshop made clear that many participants still worry, precisely because so much is available on the internet, and also because they feel uncomfortable teaching with and publishing some medical images. Open discussion and the recognition that there will be a diversity of opinions on what to show and to whom are helpful. The AboutFace project can show real leadership in fostering informed and honest conversations about what approaches will work best. In fact the project works mainly with living participants, where the existing regulations and protocols are more elaborate.

Now is a moment of possibility for historians working with medical images. We might start by asking what makes an image ‘sensitive’ or ‘difficult’, who is making that judgement, and in whose interests. We must consider whether it is right to speak and write about images that are not shown to audiences. To do so without including the visual materials, does not show our ‘workings’, that is, it does not share the forms of attentive looking that are indispensable when undertaking research on images. Without illustrations, it becomes impossible to evaluate the interpretations being offered. Ideally our accounts take both verbal and visual forms, so along with attentive looking must go an awareness of the ways in which the words we use shape responses to our work. And if we owe something to historical actors, it is to all of them, to nurses, doctors, health workers of any kind as well as to patients, their families and descendants.

An ongoing process

Attentive looking in the context of the history of medicine raises enumerable questions that may be described as ‘ethical’. It will be more productive if, having granted that ethical considerations pervade all historical practice, we work as a community on generating guidelines that suit the challenges we face. Unanimity may not be possible, and there will be an on-going process of discussion, refinement and constant reappraisal. It’s vital that these conversations are shared with audiences that are as broad as possible. It will never be feasible now to restrict the availability of digital imagery, but we can share widely our ideas about how to handle and interpret them. It will always be worth developing our self-awareness as historians, and as attentive, skilled interpreters of the visual culture generated in relation to medicine and health.

Author Bio

Ludmilla Jordanova is Emeritus Professor of History and Visual Culture at Durham University, where she was Director of the Centre for Visual Arts and Culture 2015-19. She is also an Honorary Professorial Fellow at the Edinburgh College of Art, University of Edinburgh. She has been a Trustee of the Science Museum Group since 2011, and was a Trustee of the National Portrait Gallery 2001-9.  Her books include History in Practice (third edition 2019), Defining Features: Scientific and Medical Portraits 1660-2000(2000), and Physicians and their Images (2018).  She writes about visual culture, the histories of science and medicine, cultural history and the nature of historical practice. Among her current writing plans are books on portraiture and on ethics in historical practice.

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Moebius Syndrome and Face Equality

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Moebius Syndrome and Face Equality

The Author

Patrick Adamson

Our next Face Equality Week blog is on Moebius Syndrome and face equality. It is written by Jonathan Cole, a professor at the University of Bournemouth and a consultant in clinical neurophysiology at Poole Hospital. In addition to empirical neuroscience research he believes the first person experience of impairment is essential. In this regard he has written several books, on living with severe sensory loss, with spinal cord injury and with facial disfigurement. His account of Moebius Syndrome, (The Invisible Smile, OUP), was written with Henrietta Spalding, who has the condition herself.

Moebius Syndrome and Face Equality

One of the most extraordinary things about our species is that our faces all look different, (barring identical twins); the face is a unique identifier. Whilst we accept differences within certain constraints, and indeed celebrate them, if people have differences beyond the norm or the accepted, then terms such as disfigurement appear, and people can be stigmatised. (Disfigurement being the preferred term amongst many with such visible differences). The purpose of those of us working in this area is to reduce such stigma, and to value different people and their faces, hence facial equality.

Our faces have evolved not solely to look different, but are less hairy and more mobile than other primates, to be more visible and to reflect and express our more complex emotional experience. Facial expression is so much a given, so taken for granted, that we have tended not to focus on it as an important aspect of being human, compared say with language, cognition or ever the opposable thumb. Yet it can be the cause for judgements just as damning and ill-considered as those seen in disfigurement. Some with Parkinson’s find facial mobility is reduced and can be considered to have become ‘dull and boring.’ There is, however, at least one condition in which facial mobility is absent from birth and whose experiences allow insights into facial expression which might otherwise be unobtainable and indeed unimaginable.

In Moebius Sequence or Syndrome the nerves controlling movement of the eyes outwards and of movement of the muscles of facial expression do not develop, so from birth children with the condition cannot suck, or close their mouths or their eyes. Other more variable features may include other problems with cranial nerve function leading to difficulties in movement of the tongue and swallowing, as well as abnormalities in development of the hands and feet.

Initial care may focus on feeding and then, later, on eye care and dentition. People with Moebius may require surgery to their eye lids, to their feet and hands as well as needing speech and language therapy to learn to talk without lip movement. Some are astonishingly good at this. The everyday practicalities of living without lip or eye movement, as well as many other difficulties are life-long. One person with Moebius described their body as like a ‘rusty old car,’ needing continuing medical attention.

As well as these physical difficulties, people with Moebius also have to face psychosocial problems, some arising from their condition but others imposed by others. An example of the latter is that in the past children with Moebius were thought to have an increased incidence of autism and of learning difficulties. More recent research has not confirmed this. Instead it is suggested that children with Moebius, without facial expression and frequently with eye problems and gaze palsies, as well as with difficulties in speech, have been considered autistic – the judgement of which depends, in turn, to an extent on mutual eye gaze and social success – because of their physical limitations, a sort of somatic straight-jacket. Likewise, learning difficulties faded away once people with Moebius, who unsurprisingly can have learning delays, were allowed sufficient time to perform the tests and see the questions, and properly aged and development matched. Even medical professionals have, in the past, seen physical differences and presumed illusory intellectual deficits.

Moebius is rare, so few health care professionals will meet a case. Because of this, mutual support across the community becomes more important. Organisations such as the US Moebius Support Foundation facilitate support and knowledge between and with differing age groups. Many with Moebius thrive socially, especially with good family and friends’ support, just like the rest of us. But, like the rest of us too, some do find social interaction problematic and increased rates of depression and reduced educational and work success have been reported. Children with Moebius and their parents seeking advice and support are often at the forefront of concerns, but then those children grow up. While some ages are always difficult, say adolescence, for people with Moebius, early adulthood, watching friends start families when they might not be, can be additionally problematic. When considering facial equality, age related phases of life should not be forgotten.

Some with Moebius, again like the rest of us, develop excellent social skills but a few can find these difficult. A few also describe a childhood with impoverished emotional expression and indeed experience, possibly as a consequence of reduced bodily expression and social reinforcement. It is important to introduce emotional and social experience, by encouraging talking about feelings and by the increased use of gesture and prosody.

Conversing with people with Moebius, one soon learns to tune into conversation without facial expression, with nuances of meaning revealed elsewhere. One person told me of taking her wedding photos into work. Someone said, ‘But you are not smiling.’ Despite working with her for years, they had not realised she lacked a visible facial smile, so successful was she in conveying emotion through other channels.

When considering face equality one might, naturally, focus on appearance, and disfigurement. But those with Moebius and, say, with Bell’s palsy have reduced or asymmetrical movement of the face, while others, such as with Blepharospasm and torticollis, have unwanted movement. Faces have both a static appearance and have evolved to be dynamic reflections and read-outs of emotion. Face equality is about both appearance, and expression and movement. An increased appreciation of the diversity in faces is not only a humane imperative, we can all learn much from those who live with conditions which question our normal assumptions about faces.

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Framing the face: history, emotion, transplantation

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Framing the face: history, emotion, transplantation

The Author

James Partridge

Guest blog by James Partridge, Director of Face Equality International

Framing the face: history, emotion, transplantation

As far as I am aware, there have been very few inter-disciplinary research projects focused on the human face — perhaps the Future Face exhibition in 2004 at the Science Museum curated by Prof Sandra Kemp came closest in encouraging many contrasting and inter-connecting perspectives: the evolutionary, biological, basic science, anatomical, surgical, psychological and artistic (to name a few!).

A very eclectic and thought-provoking array of artefacts, images and articles from pre-history looking right into the next millennium were assembled — and, happily, Changing Faces had a small but significant pitch with our early posters displayed, one of which was of a man’s face with a complex birthmark over one eye with the epic line: “Hello. Nice to meet you. How are you? Now you try it.”

I was reminded of that exhibition as I prepared to take part in the launch event of the About Face project because ‘framing the face’ brought to mind portraiture — and how lucky we were to have Lucy Burscough’s highly insightful paintings of facial cancer patients to view at the launch. I decided to show some of Henry Tonks’ pastels of WW1 soldiers who endured the pioneering facial surgery and oral scaffolding of the famous dentist-cum-ENT-surgeon-cum-plastic surgeon, Harold Gillies. And photos of Les Gueules Cassées, the French association of facially-injured veterans and, of course, the reconstructing faces of the fighter pilots of Archibald McIndoe’s Guinea Pig Club.

The surgical techniques developed in those years meant that those injured in other wars like Vietnam and Afghanistan were given another chance… people like me, injured in a trivial car fire in 1970, and many many others with other facial conditions — such as cleft lips and palates, cranio-facial syndromes, facial cancer and paralysis — could be offered somewhat less noticeable facial looks. And, let us not forget, those techniques have also evolved to become the daily bread-and-butter methods of the cosmetic surgery industry, now a multi-billion-pound phenomenon worldwide.

So, the history of ‘modern’ facial reconstruction is really only just over a hundred years’ long (although earlier surgery had its successes too). Patients who consent to face transplantation are taking ‘a leap into the dark’ as the Royal College of Surgeons’ report of 2006 described it just as those who ended up at Queen Mary’s Sidcup in Gillies’ care did or at the Val de Grace in Paris [do watch the video ‘The Officers’ Ward’ set in that hospital if you haven’t]. And plastic surgery in the future? Safer transplants, 3-D scaffolding, stem cells… who knows? The specialty has great ingenuity but most plastic surgeons also acknowledge its aesthetic limits.

All this is going on as life in today’s incredibly visual culture is increasingly face-focused… we live in a ‘perfect-face’ culture more than ever before. And that poses great hazards for anyone with a ‘less-than-perfect face’. The 1990 observation by Frances Cooke Macgregor1, the American social anthropologist who followed Vietnam veterans with facial disfigurements back into their communities is arguably even more true today: “people with disfigurements experience a loss [or lack] of the civil inattention that most people take for granted”.

Learning how to manage that successfully is no cake-walk. It took me years2. The pro-active social skills programmes which Changing Faces invented and were proven effective by researchers like Nichola Rumsey, Alex Clarke3 and Alyson Bessell4 need to be made much more widely available.

With the pressures of social media to contend with, the hype of cosmetic surgery all around and the nasty stereotypes of Hollywood villains in the background (sometimes foreground), daily life is far from straightforward and often downright unpleasant. Staring, intrusive comments and trolling seem to be almost the accepted norm. Hate crime legislation hardly touches them. Never has there been such a pressing need for more of the public education evident in that poster: “Now you try it.”

So, my hope is that the About Face project encourages new inter-disciplinary efforts not only to enable surgical advances but also to re-ignite the psycho-social interventions designed to empower people with facial disfigurements of any cause to face their futures confidently, negating the stigma they are bound to face. And gives further impetus to public awareness/education efforts to ensure the prejudice-free social inclusion of people with distinctive faces… which is the ultimate goal of the campaign, soon becoming a global movement, for face equality (like race equality).

  1. FC Macgregor (1990) ‘Facial disfigurement problems and management of social interaction, implications for mental health.  Aesthetic Plastic Surgery 14(4) 249-57

  2. Partridge, J. (1990 and 2012). Changing Faces: the Challenge of Facial Disfigurement. London: Penguin and Changing Faces. Available from JP on james.partridge@faceequalityinternational.org

  3. Alex Clarke et al (2014) CBT for Appearance Concerns. Wiley Blackwell

  4. 30. See also www.faceitonline.org.uk which was very successfully evaluated in this study using an RCT methodology

Face Equality International: www.faceequalityinternational.org

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