This chapter surveys views of racial and ethnic identity and discusses the way that racism and heterosexism, and the ideologies that sustain them, produce narcissistic wounds that are then enacted consciously and unconsciously in the clinic. I present several enactments of my racism and heterosexism in work with an Asian American patient. Through this work, I began to recognize unconscious cultural underpinnings of how I had thought about some “basics” of psychoanalytic practice: dependence, independence, happiness, and love. Later reflections revealed how my own cultural identifications and disidentifications, particularly around whiteness, were enacted in the work.