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Robert A. Cohen
NIMH 1952-1981

This is an interview with Dr. Robert A. Cohen, former Director of NIMH Clinical Investigations from 1952-1968, and Deputy Director of the NIMH Intramural Research Program and Director of the NIMH Division of Clinical and Behavioral Research (1968-1981). 

Interviewee:    January 18^th 2002, Bethesda, Maryland
Interviewer:     Dr. Ingrid Farreras, NIH History Office.

Farreras:          Why don’t we begin with your telling us a little bit about your family background before we discuss your education.

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Cohen:             No, we were all working together as a group.  During the war Mabel had worked full-time at Chestnut Lodge Hospital in Rockville as had her friend Josephine Hilgard.  They had finished psychoanalytic training at the Psychoanalytic Institute and were three years ahead of me.  Mabel had also served as a consultant to OSS Jack Hilgard, Josephine’s husband, who was later to become Chairman of Psychology at Stanford.  They were examining people who were volunteers to go overseas. After release from active duty in April 1946 I divided my time between private practice and Chestnut Lodge, where I shared an office with Larry Kolb, who was working at NIMH at the time. In 1948 I went full-time to the Lodge; I was appointed Clinical Director, continuing classes at the Psychoanalytic Institute from which I graduated in 1950 and finishing analysis with Frieda Fromm-Reichman.  In addition, I was Consultant in Psychiatry to the National Naval Medical Center and served also on the Panel on Human Relations and Morale of the Research and Development Board of the Defense Department. Larry [Kolb] and I were both examiners for the board exams and we were in Frank Braceland’s group of examiners.  We were among the group of people who were active in the relative beginning of the psychoanalytic movement.  When I started as a resident in psychiatry, there were 1889 members in the American Psychiatric Association, and probably no more than 100 were psychoanalysts.^[1]  The new president of the American Psychiatric Association was always invited to join the group of examiners, so that’s how I met Bob Felix.  George Raines, Chief of Psychiatry in the Navy, had decided that the medical officers in the armed services should be analytically trained.  I won’t go into the difficulties and the problems that caused, but at least Bob Morse and I were appointed by the Psychoanalytic Society to work out a program where it would be possible for five military officers a year, Navy and/or Army, to get analytic training for four years, which was somewhat of an achievement with the rigidities that already existed there.  So I guess my having a Ph.D. degree, an M.D. degree, and psychoanalytic training led Bob Felix, late in the summer of 1952, to offer me the job of developing the Clinical Research Program at the Clinical Center – with 100 beds on six wards, two on each of the three floors – which was to open in March 1953.  Bob Felix had decided to go into analysis himself so he’d learn something about all of this and had taken courses at the Washington School of Psychiatry.  Seymour Kety had also tried, unsuccessfully, to recruit a psychiatrist.  Then Bob Felix asked me. I agonized about it and thought the plans were utterly and completely crazy.  I asked Felix what sort of program he had in mind and he said, “Anything, anything that you want to do.  You can have $1 million to hire staff.  Don’t worry about nurses or social workers; they’ll be hired out of the hospital budget.  You can go anywhere in the country or out of the country to observe the work underway or bring in consultants.  You can invite anybody to come.”  My $15,000 salary would be the top of the Civil Service scale – all others would be lower, but within that constraint it was expected that I would have at least $1,000,000 to start out. There was no flexibility with respect to the opening date; Congress had been promised that research would begin in March. He agreed with me that ideally it would be preferable to grow more slowly, to have time to find several senior staff and to develop with them the program that would be instituted. But he was certain that we would have complete freedom and full understanding from experienced administrators. He introduced me to leading administrators in each Institute, partly, I imagine, to expose me to them as much as them to me. I knew several members of the NIMH staff.  John Eberhart, Director of Extramural Research, had visited Chestnut Lodge when Stanton and Schwartz applied for a grant for the sociological study of a mental hospital ward.  It was the 51^st grant approved, one of the earliest in that program.  Donald Bloch from the Lodge staff had enlisted in the PHS Commissioned Corps and was working in the office of Dr. Joseph Bobbitt, head of the Community Service Division.  Wade Marshall had set up a very sophisticated physiological laboratory even before the creation of the Intramural Program. I knew of John Clausen’s earlier studies at the Institute for Juvenile Research although he came there long after I had left.  More recently he had carried out important studies at the Public Health Center in Hagerstown.  Marshall and Clausen already were established as branch chiefs in Kety’s Basic Program. I was deeply conflicted by the offer. On the one hand I felt that the government taking responsibility for a widespread human problem was socially very desirable. While the salary was low – I was getting $17,500 at Sheppard Pratt – my wife and I were fortunate in that together we would continue to have an adequate income. But the prospect of rushing to create a functioning world class 100-bed research institute with one senior person meeting a newly formed group of men and women who had never worked together within the larger setting of a 500-bed hospital similarly constituted seemed like attempting to unscrew the inscrutable in the words of my old professor Adolf Meyer.  I called Felix and declined his offer. But my conflict was obvious.  A week later he called to say he could offer me two or three additional senior super grade positions.  I thought it would be worth a whirl.  I spoke to people who were being called up because of the Korean War and several good people said, “Well, we’ll come” so I accepted Felix’s offer and came toward the end of 1952.   Before the Clinical Center opened the professional specialty boards had agreed to recognize two years of service in the various specialties as counting toward certification. The Korean conflict was in full sway in 1952.  Men who had been too young to be drafted during World War II were being called to active duty; many preferred the Public Health Service to the military. I was literally deluged with applications, and had my choice of men who were being trained in excellent medical school departments.  I tried to find young women, too, but succeeded in recruiting only one – Julianna Day from Johns Hopkins.  I  approached men and women at the professorial level whom I knew personally or by their publications.  I covered the country from coast to coast and border to border but totally without success. Three longtime colleagues who were superb clinicians and highly regarded teachers who had not served during World War II said they would come if they were called up for service. Then the war ended and they sent me best wishes. So here I finally had accepted this position and the men who had told me they’d come called me to say they were not drafted.  There I was, with no staff.  Then many residents in psychiatry applied and that’s how we started. The structure of the Clinical Center at the time was actually a little different than it seemed.  Seymour Kety was the Scientific Director of both NIMH and NINDB.  In ordinary circumstances, the Scientific Director would be the one in charge and my superior, but it wasn’t that way.  He was the Scientific Director but he had no clinical experience so he tried to find a psychiatrist and made offers but had had no luck.

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Cohen:                         Before I reported for duty the first senior investigator I recruited was Fritz Redl.^[2]He was the only person who came who already had an established reputation.  He was Distinguished Professor of Behavioral Science at Wayne State. He had been a student of the established psychoanalyst August Aichorn in Vienna (the author of Wayward Youth).  He was widely known for his studies of the disorganization and breakdown of behavior controls, and had a degree of success in developing treatment programs for these difficult children.  Among his books were Children Who Hate and Controls From Within, about hyper-aggressive, antisocial children.  He was a graduate of the Vienna Psychoanalytic Institute; a fellow student with Erik Erikson with whom he had kept in close touch as they formulated their ideas. So he was the first person who became part of what I looked upon as a permanent staff.  Most of the others were qualified to fill temporary positions. I wanted to have the sort of organization that I had dreamed of as a possibility.  In the early days I talked to many colleagues about the areas of research in which we might be engaged and the disciplines that might be represented. We might study behavior disorders in children, mood and thought disorders (manic-depressive and schizophrenic patients), and psychosomatic disorders (disorders of body function) – and in every instance take advantage of our freedom to study and compare patient behaviors and processes with those of normal controls.  The disciplines represented would include psychiatry, clinical and developmental psychology, sociology, anthropology, physiology, biochemistry, and pharmacology.  These, of course, were day dreams that at best would be implemented one segment at a time; but one essential difference between the program I envisioned and that of any psychiatric organization of which I had been a part was the hope that the study of the clinical condition would always be interdisciplinary and that whatever was studied in the pathological would be studied as well in the normal.  I had in mind a variation of the model of the Physiology Department in which each member of the faculty was engaged in research in one system: e.g. the digestive, the endocrine, the circulatory or the nervous, but where everyone kept abreast and was concerned with all advances in each area. I called several younger men whom I had met in recent years for whom I had high regard:  Morris Parloff in psychology, Roger MacDonald in psychosomatic medicine, Charles Savage and Irving Ryckoff in psychiatry.  I had interviews with a multitude of residents and tried to choose from among them those whose interests and/or experience fell within the several areas of study in which I hoped we would engage.

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                        forward to learning more about the later years at our next meeting. 

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Footnotes

[1]  When I began residency training in psychiatry in September 1937 it was not a widely accepted specialty.  My 1935 class at the University of Chicago did not have a single lecture in the subject; my wife’s 1937 class had six lectures.  Harvard, Yale, Columbia, Michigan and Iowa had residency programs as did some of the large private mental hospitals and a number of State Hospitals.  In September 1937 there were 1889 members of the American Psychiatric Association.  The American Board of Psychiatry and Neurology had just been established in 1936 – many years after such Boards had been established in medicine, surgery, cardiology, obstetrics and gynecology, ophthalmology and other specialties.  It would require three years of residency training, two years of practice for eligibility to take the examination.  In 1937 there was only one staff member at Johns Hopkins who had taken and passed the examination.  By World War II there could not have been more than 3000 psychiatrists; by 1967 there were 15,813 – largely the result of the financial support of NIMH.

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