The author proposes the importance and relevance of working with primitive mental states in couples and that a failure to recognise and work with these states can lead to a therapeutic impasse. This article highlights how an understanding of such a mode of psychic experience has emerged largely from work with individual patients. Moreover, it suggests how couples presenting with such primitive mental states require the analyst to be available as an undifferentiated object. This provides a containment function that allows for psychic transformation and growth. Couples whose psychic function has been derailed to such a regression point are thus allowed to regain their usual level of functioning. This outcome in turn provides a platform for further growth which involves the capacity to work with symbolic processes. It is proposed that such understandings and ways of working with primitive mental states and their associated anxieties have a cross-cultural applicability.