This chapter discusses the specific challenges ethnic and racial minorities face in regards to developing a healthy self-esteem and the consequent vulnerability to shame that may accompany that. Paradoxically sensitivity can inhibit the psychotherapeutic dyad from talking about important elements in a patient’s family history, cultural experience, intrapsychic dynamics, and transference-countertransference issues that would enliven and enlighten the work. When a child experiences a pattern of rejections and ruptures, feelings of self-doubt as well as mistrust of the holding environment can develop. While all people experience feelings of shame, for some it is a more pervasive experience. The environmental factors that contribute to a susceptibility to feeling shame are in place. The chapter highlights the ways that the experience of growing up as a minority person can compromise one’s ability to trust others and to consolidate a positive sense of identity.