Racial loneliness is a phenomenon experienced by individuals of color in predominantly white settings, including the predominantly white clinic. This paper identifies key psychoanalytic underpinnings of racial loneliness, drawing upon theory from Klein, Fanon, Layton, Eng and Han, and Okun. In doing so, this paper explores racial loneliness and its treatment implications. Through a deepened understanding of racial loneliness, the isolation and exclusion of clinicians of color within psychoanalysis is interrogated. A clinical vignette is deployed to explore the effects of racial loneliness on treatment, identifying unique challenges in the realms of countertransference, self-disclosure, and identification.