Great music is linked to troubled composers, a psychiatrist-pianist says

By: Marianne Scegedy-Maszak

Unbalanced Minds and MusicRICHARD KOGAN’S INTEREST IN THE LINK BETWEEN MENTAL illness and creativity is more than a mere academic sideline. As a psychiatrist and director of the Human Sexuality Program at New York Presbyterian Weill Cornell Medical Center, and a concert pianist, he has examined the psycho-pathology of some of the great composers —Schumann, Tchaikovsky, Beethoven, even George Gershwin—and explored its effects on the composers’ music. A musical prodigy himself Kogan began performing in 1961 when he was 6 years old. But the world of medicine was never far from the family life. His father was a gastroenterologist and took his precocious son “Ricky” on medical rounds. Several years later, as a Harvard undergraduate, Kogan became close friends— and performed—with classmate cellist Yo-Yo Ma. Kogan continued to mix music and medicine by going to Harvard Medical School under a special five-year plan that enabled him to travel and perform concerts. Since then he has had a distinguished career both as psychiatrist and as a musician. He spoke to U.S. News after he played the music of Tchaikovsky for an audience of psychiatrists at a forum on music and mood disorders.

How does understanding the context of a composer’s life and his psyche affect your performance of his work?

Music is just notes on a page, and if you train enough or practice enough you can play those notes on the page. But really to animate those notes, performers have to have some understanding of what makes their meaning. I have played Tchaikovsky First Piano Concerto for 25 years. But now, clearly knowing how depressed he was and how desperately he suffered to keep his homosexuality hidden, and then how desperately he had to create this lavish fantasy world, creates a type of urgency that I put in my interpretation of the piece.

How do you see the interface of madness and music in the lives of some of the great composers who we know were mentally disturbed?

Robert Schumann had what we would now call bipolar disorder. It wasn’t called that then, but everyone knew he was touched. In the 19th century, not only in the music but literature and the arts, you were expected to have a little mental disorder in order to be taken seriously. Schumann knew that when he was manic, he was explosively creative. One of the features of a hypomanic state is that one needs so very little sleep, so he had 20- to 22-hour days. He wrote three string quartets in two weeks, 138 songs in one year. Then he would become so depressed he would shut down and not be able to compose at all.

What were the treatments then?

Schumann sought out all the psychiatric help that was available in 19th-century in Germany. Which, unfortunately, wasn’t much. Hydrotherapy involved a lot of hot baths. He was hospitalized in an insane asylum. One doctor told him that he was composing so much he was depleting himself of his energy. At that point Schu-mann found himself another psychiatrist—that was not what he wanted to hear.

But if you look at his genius and the profusion of ideas, his mental illness was also useful.

Definitely. Those who had a mental illness all suffered enormously, and in every case their illness created certain handicaps. When Schumann was hypomanic, he wrote a lot and really well and with great energy. When he was depressed he couldn’t compose . On the other hand, when Tchaikovsky was really depressed, that stimulated composition. But, had he not been so depressed, he would never have killed himself at the height of his creative genius.

Would the music have dried up if they had been medicated?

I think that if Tchaikovsky had current treatment that would have relieved some of the unbearable mood states, he would have taken it. If he noticed that he was not as productive, that his music wasn’t quite as powerful, I think he would have stopped the treatment . These great geniuses seem to have an imperative, that what they are creating is more important than anything else in their lives.

What was the psychopathology of George Gershwin?

Gershwin wasn’t really exposed to music until he was 9 or 10. When he was 8 and 9 years old he was the classic bad kid—kicked out of school; people said he was studying to be a juvenile delinquent. If he had grown up in the late 20th century, he would have seen a child psychiatrist and been labeled as having attention deficit disorder. (ADS) When he was in his mid-30s—world famous, at the peak of his career—he became severely, pathologically depressed. He went to a brilliant psy-choanalyst and was in treatment five days a week for two years . At the same time he was writing his opera Porgy and Bess. Within two years of his depression, he collapsed and doctors discovered a massive brain tumor. I am convinced his depression was secondary to his brain tumor. This is not a psychiatric success story.

How did all this influence his music?

The music of Porgy and Bess is so much more somber than anything else he wrote. He wrote so many love songs, his music is so jaunty. But this music is full of real anguish—the most moving music he ever wrote. To my mind it is no coincidence that this depressed man, who is essentially dying of a brain tumor, is writing melancholy, much more profound music.

Isn’t it dangerous to retrospectively or posthumously diagnose historical figures?

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 most 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.

In psychiatry, you specialize in sexual dysfunction and treating sexual problems. Is there some overlap between sexuality and music? Just look at the language—climax, rhythm, harmony, fantasy. In the structure of pleasure, the same rules apply in both sex and music. Many pieces of music al most exactly follow the human sexual response cycle that Masters and Johnson outlined --the desire phase followed by the excitement phase, followed by the arousal, and orgasm, followed by resolution. What great composers discovered is that music is a set of expectations. You expect a certain core progression and you expect that it will resolve somewhere. If, instead of resolving there, you deviate, you can actually build up to a different level of excitement.

You have talked about how your understanding of psychiatry has informed your music. Does your understanding of music inform your work as a psychiatrist? Definitely. If I were a pathologist or a radiologist, I would say that playing music relaxes me . But I can honestly say that because of it, because of my access to another aspect of the profound mysteries of the mind, I am a better psychiatrist..


                                                      U. S. NEWS & WORLD REPORT

                                                             January 13, 2003. (Pgs. 45 - 46)

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