Excessive anxiety about being selfish can, paradoxically, lead to an unconsciously motivated lack of concern about the impact of one's desires on others. That which is repudiated by the patient as “not me” may become enacted between the patient and analyst, and then become subject to formulation and exploration. Two cases are presented in which excessive worry over selfishness creates unconsciously motivated self-centered behavior, and resulting relationship difficulties and transference-countertransference enactments. The author suggests that extreme anxiety over selfishness may be partially engendered by a lack of intersubjective recognition of desires in early life. The notable lack of language in English that embraces the positive aspects of self-interest is also discussed.