In this article, the author discusses common ways in which couple consultation and therapy are practiced by psychoanalysts and the limitations of each. The author argues for an approach to the assessment and treatment of patients who present with a disturbed relationship that addresses the vicissitudes of unconscious collusion and develops this principle as a fundamental criterion for making the recommendation of couple therapy over psychoanalysis or psychoanalytic psychotherapy. The author then elaborates an understanding of a variety of obstacles, those emotionally determined and those determined by analytic ideals, which limit the analyst's freedom to assess the most appropriate modality and to conduct couple therapy within the psychoanalytic model described.