It's impossible to appreciate life here without considering Baltimore's psychology. Freud cautioned against "wild" analysis — efforts at understanding art, culture, history, (or a city) through a psychological lens. Nevertheless, wild analysis may be what we attempt this week, when hundreds of psychoanalytically-minded clinical social workers from around the country come to Baltimore for the biennial American Asssociation for Psychoanalysis in Clinical Social Work (AAPCSW) conference, and we introduce them to our city — the birthplace of American psychoanalysis.

As psychotherapists with over 30 years experience, we still look to our patients to teach us about their multiple Baltimores. But Baltimore has a certain psychology, a sublime sensibility at once obvious and ineffable, not unlike the unconscious itself: tender and tough, wounded and surviving, swaggering and fearful, Northern and Southern, black and white. The resigned resilience many of our patients embody transcends the quirky eccentricities of a John Waters movie or the bleak urban and institutional wastelands of "The Wire."


In the aftermath of the 2015 uprising, perennial issues tumbled forth from the tumult of Baltimore's psyche, settling along the fault lines of violence, class and race.

Our former mayor had already designated Baltimore a "trauma-informed city." Baltimore is widely considered one of the most addicted cities in the country. Nearly 25,000 people struggle with heroin addiction and its medical, psychiatric and psychosocial comorbidities. A black male here is 30 times more likely to be murdered than the average American, making for a murder rate in black Baltimore that ranks fifth in the world. Perhaps equally violent is what one black psychoanalyst described as a lifetime spent subsisting on racial microaggressions — racism that, as one of our black patients noted, had gone underground for a time, only to re-emerge with a vengeance in the wake of the recent election. While the violence disproportionately affects its African-American communities, Baltimore remains one of the most violent cities in the world.

Baltimore has fallen on hard times. Over 10 percent of the city gets by on federal disability payments. Struggling to appeal to a younger, more affluent demographic for over 30 years, its population continues to decline. The burden of poverty is borne by all residents through decaying infrastructure, under-resourced schools, largely inefficient government bureaucracy and a police department in which 79 percent of its officers live outside the city.

In 1910, Baltimore city government adopted one of the first residential segregation ordinances in the country, restricting African Americans to designated blocks. The residue of red-lining reverberated through the riots of 1968 and the uprisings of 2015, concentrated in neighborhoods that have been ghettoized for a century.

These historical threads weave a complicated symptom in the Baltimore psyche that coexists with personal narratives of transcendence and transgression. The stories our patients tell themselves about themselves are full of suffering, but also of the overcoming of it. And there are unique and largely unappreciated psychoanalytic stories rooted in this city as well.

Baltimore's psychology includes its locus as the birthplace of psychoanalysis — one might even say of the unconscious — in the United States. In 1911 the American Psychoanalytic Association was established in Baltimore, home of Johns Hopkins Hospital and psychiatrist Adolf Meyer. Originally from Zurich, Meyer was taken by Freud's ideas, then considered the leading edge of science. He was instrumental in formalizing psychiatry as an academic medical discipline, founding the first inpatient unit of a general American hospital designed to treat those with mental illness at Hopkins in 1913.

Baltimore functioned again as a lure for psychoanalysis in 1966, when the French Freudian, Jacques Lacan, arrived here on the first stop of his inaugural trip to the U.S. to speak at Johns Hopkins University. Lacan's remarks are memorable:

"When I prepared this little talk for you, it was early in the morning. I could see Baltimore through the window and it was a very interesting moment because it was not quite daylight and a neon sign indicated to me every minute the change of time, and naturally there was heavy traffic, and I remarked to myself that exactly all that I could see, except for some trees in the distance, was the result of thoughts, actively thinking thoughts. ... The best image to sum up the unconscious is Baltimore in the early morning."

Lacan locates the unconscious, the sublime nexus of all our psyches, in Baltimore in the morning. The unconscious, he tells us, is like dawn — that threshold between sleep and waking. It's a pulsating neon sign, ticking time, advertising enjoyment. It is intermittent and fading, present and absent. The unconscious is like Baltimore, with its sublime oscillations between tender and tough, wounded and resilient, swaggering and fearful, Northern and Southern, black and white.

According to Freud and Lacan, there is no universal "dream book," meant to provide facile interpretations to every dream image. Neither is there an easy decoder ring for the psychology of Baltimore. Every resident must tell his and her own story of the psychology of this place. Yet we all awake each day into the unconscious that is Baltimore in the early morning, a sublime place, both horrifying and beautiful.

Teresa Méndez (tmendez@baltimorepsychotherapy.org) is a former staff writer for The Christian Science Monitor turned clinical social worker; she practices in Baltimore. Daniel Buccino (dbuccino@jhmi.edu) is clinical director of the Mood Disorders Clinic at Johns Hopkins Bayview and director of the Johns Hopkins Civility Initiative. They are members of the AAPCSW.