Heart is from Cohen's work in Pierrot Lunaire, based on the dark, caustic, and poignant 1912 song cycle by Arnold Schoenberg. The etchings are printed twice on each page—in intaglio and relief, a visual analogy to the sudden and startling reversals of emotional tone from tenderness to despair in the music. He embraces themes of loss, futility, destruction, and unexpected, redemptive beauty, themes tied to the tradition of printmaking, whose imagery has always tended toward critical commentary and serious contemplation, and often toward humor and irony as well. He is as often inspired by what he reads or listens to as by what he sees. He looks back at images from old postcards and photographs, or at older books. The process of etching is physical and elemental, requiring force and pressure, inviting aggression and then delicacy, conjoining fire, water, earth, and air. There is something about setting an image into metal that implies permanence, duration, and enduring presence.

Artist’s books and prints by Brian D. Cohen have been shown in forty individual exhibitions, including a retrospective in 1997 at the Fresno Art Museum, and in over 200 group shows. Cohen's books and etchings are held by major private and public collections throughout the country. He was first-place winner of major international print competitions in San Diego, Philadelphia, and Washington, DC. His essays on the arts and education are a regular feature of the Arts and Culture section of the Huffington Post.