For many years, the negative therapeutic reaction (NTR) was regarded as a form of resistance arising solely in individual psychoanalytic treatment. The possibility, however, that the NTR may also appear in couples has recently emerged as worthy of exploration. After presenting a case in which NTR dynamics predominate, and reviewing analytic literature about the NTR, the authors propose a conceptualisation of a couple-based form of the NTR that relies upon both paradoxical motivations and paradoxical uses of projective and introjective identification. The countertransference reactions these couples tend to induce in therapists will also be explored, and methods for their management will be suggested.