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This article addresses the context in which Chestnut Lodge Sanatorium evolved its legendary status. Early years of interpersonal psychoanalysis (1920s–1950s) locate the Washington, DC, and Baltimore areas as crucial contexts, both for the professional support they provided to the beginnings of an interpersonal viewpoint, and for the derisive, dismissive attitudes targeting the early proponents of the interpersonal perspective. Chestnut Lodge and the developing White Institute evolved along parallel organizational lines. The development of a compatible clinical sensibility is noted, conceptually linking those identifying as “interpersonal.” Both organizations (“The Lodge” and “White”) share a common intellectual ancestry and a comparable approach to clinical technique. Likewise, both organizations share an emphasis on rejecting dogma and managing to resist organizational pressures in favor of nonconformity and defiance of rigidity. Both organizations are shaped by theorists who are drawn to work intensively with “difficult” patients, as well as with facing powerful personal and political challenges and credible threats of professional exclusion.