Richard Kogan (physician)

Richard Kogan (born 1955) is Clinical Professor of Psychiatry at Weill Cornell Medical Center; Co-Director of the Medical Center's Human Sexuality Program; and Artistic Director of the Weill Cornell Music and Medicine Program.
He also conducts a private practice of psychiatry in New York City.
In parallel with his medical vocation, Kogan pursues an equally serious vocation as a concert pianist. This unique combination of accomplishments has led him to develop a series of renowned lecture-recitals that explore the role of music in healing, and the influence of psychological factors and psychiatric and other medical illness on the creative work of composers.

Richard Kogan

Richard Kogan is the son of a gastroenterologist from Elizabeth, New Jersey, the second of five children. A musical prodigy, he began piano performances in 1961 at age 6. But the world of medicine was never far from the family life; his father took his precocious son on medical rounds. His mother, for her part, enrolled him at the Juilliard School of Music Pre-college, where he studied piano with Nadia Reisenberg.

At Harvard University, where he studied music (his major) and completed a pre-medical curriculum, Kogan formed a trio with his Juilliard friend Yo-Yo Ma and with violinist Lynn Chang. After earning a bachelor's degree at Harvard in 1977, he went to Harvard Medical School under a special five-year plan that enabled him to travel and perform concerts.

Kogan received his M.D. degree from Harvard Medical School in 1982. He completed a psychiatry residency and an academic fellowship at New York University.

In 2001, Kogan presented a symposium at the American Psychiatric Association on mental illness and musical creativity. The resulting experience was a revelation to him and launched him on a new career. It brought home to him that exploring the psyches of composers made him a better interpreter of their scores, and that understanding the role of music in people's lives made him a better psychiatrist.

In considering composers for his lecture-concerts, Kogan selects ones who had intrapsychic conflicts that affected their creative processes, and who wrote for the piano so that he can illustrate his points with musical examples.

He often uses an anniversary as a pretext to explore a certain composer. In 2010 he presented Chopin on the bicentennial of his birth. In 2006 he explored Mozart's mind and music during his 250th anniversary year. In 2007 he presented Leonard Bernstein on the 50th anniversary of the world premiere of West Side Story.

Asked whether it is possible to diagnose psychiatric conditions in deceased composers, Kogan responds:

People often say you can't really diagnose anybody you have not had face-to-face interviews with because it is conjecture at best. But Tchaikovsky was a prolific letter writer, he wrote 1,400 letters to his patron, and they were very intimate letters. He clearly had a major depressive disorder; Schumann was clearly bipolar. Beethoven was interesting; I have had trouble getting a good fix on his diagnosis. He had substantial psychological issues with tempestuous mood swings. He was unquestionably depressed. He had suicidal thoughts though he never made a suicide attempt. And he had clear, overt, psychotic behavior, especially at the end of his life. It is difficult to factor in how much his irregular behavior and eccentricities were influenced or exacerbated by his progressive hearing loss. When I talk to audiences about this, people often come up and say, "I have heard this piece a million times, but I have never heard it that way." I don't think they are talking about the uniqueness of my interpretation, I think they are talking about their understanding of the psychological and historical forces that went into making that piece.

Kogan points out that a number of famous composers have suffered from mental problems that seem to have both enriched and complicated their music, and certainly complicated their lives. Prominent among them have been:

Ludwig van Beethoven (1770–1827): His hearing loss, and syphilis, may have induced psychosis.

Robert Schumann (1810–1856): Manic episodes in the course of his bipolar disorder brought periods of explosive creativity, but he died in a mental institution by self-starvation.

Peter Ilich Tchaikovsky 1840–93): As a closeted homosexual in czarist Russia, he was deeply depressed for many years and may have ended his life by suicide.

George Gershwin (1898–1937): Psychoanalysis could not relieve depression triggered by an undiagnosed brain tumor which eventually killed him.

Some other composers' lives, though also marked by periods of mental illness, did not end quite so tragically. Sergei Rachmaninoff (1873–1943), following the disastrous premiere of his Symphony No. 1, suffered for three years from a debilitating depression that prevented him from composing. After his psychiatrist, Nikolai Dahl, cured Rachmaninoff's creative block through hypnosis and psychotherapy, the composer produced his celebrated Piano Concerto No. 2, dedicated to Dahl.

Kogan hastens to add that, while writers and artists have mood disorders in greater proportion than the general population, mental illness is not a prerequisite for creativity. "There have been examples of great composers, such as Bach, Haydn, and Mendelssohn, who seem to have been relatively free of significant psychopathology."

Kogan, director of a human-sexuality program, sees links between music and human sexuality:

There’s a common vocabulary between the two: fantasy, rhythm, harmony, climax... Masters and Johnson tried to define the phases of sexuality with scientific rigor — stages of desire, arousal, climax, and resolution. Many very great pieces of music follow the same arc. Music can get everybody in the room to feel the same way at the same time, and everyone will agree on the climax of the piece. Great composers don’t give you immediate gratification; they set up an expectation and then veer you away somewhere else, so when you finally get a release, the resolution is more powerful and more satisfying. There may be a basic mechanism that is common to all pleasure.

While trained as a classical musician, Kogan expresses "a deep appreciation for a wide variety of musical genres.... I am generally opposed to arbitrary stylistic distinctions. I agree with the viewpoint of Duke Ellington, who once said, 'There are only two kinds of music — good music and bad music. I like both kinds.'"

Over the years, Kogan says, he has had at least a dozen favorite composers, including Bach, Mozart, Beethoven, Schubert, Chopin, Brahms, Debussy, Stravinsky, Bartók, and Shostakovich. "My favorite composer seems to be the one whose musical world I've been immersed in most deeply at any given time."

In Dr. Kogan's medical specialty, psychiatry, today's overarching paradigm is the biopsychosocial model. This model holds that mind, centered in the brain, is an integral part of the body, and that both mind and body also interact with the social milieu. Each of the three factors — biology, psyche, and society — interacts with, and affects, the other two.

Kogan points out that listening to, or playing, music reduces stress levels by releasing the hormone, cortisol, and can reduce pain.

Music boosts immunity and releases dopamine, a brain neurotransmitter which is also released during other pleasurable activities such as sex or indulgence in good food.

Music benefits heart patients by reducing high blood pressure; in stroke patients, it helps restore speech and motor functions; and in the elderly it helps arrest cognitive decline. Music can enhance the motor functioning of persons suffering from Parkinson's Disease.

"Music needs to be part of the healing techniques adopted by a psychiatrist," says Kogan. "It should not replace traditional medicine, rather supplement it. We need to make it a part of traditional therapy, as it makes the recovery faster."

Kogan recommends that his patients not just listen to music, but make it themselves.

"I especially recommend community listening or playing, where the entire group is enjoying rather than merely tuning in to iPods and other gadgets."

• Music and the Mind: The Life and Works of Robert Schumann (DVD), Yamaha Touchstar Productions.

• In a review of this DVD, Yo Yo Ma has written: "I came away from this extraordinary lecture and performance deeply moved by a fascinating presentation that only Dr. Kogan, psychiatrist and concert pianist, can deliver... Through a unique combination of brilliant psychiatric insights and superb musicianship... Richard Kogan presents a rich multidimensional profile revealing some of the most intimate sources of Robert Schumann's enormous creativity, imagination and artistry." Quoted in Nevada Psychiatric Association, Course Syllabus, 18th Annual Psychopharmacology Update, p. 217.

• Concert Artists Guild Award
• Kosciuszko Foundation Chopin Competition
• Liebert Award for Applied Psychoanalysis
• McGovern Award for the Art and Science of Medicine
• American College of Psychiatry Public Service Award
• Eighth annual Joan and Stanford Alexander Award in Psychiatry, presented to Dr. Kogan at Baylor College of Medicine, April 6, 2016.