Mary Beth told me that she was backsliding, losing whatever progress she had made in the last six months of therapy. She was spending more time with her parents and her sisters during the holiday season and feeling "guilty around the clock." I asked her to tell me more about her constant guilt.

"I've always felt guilt easily, you know, assuming the blame for just about anything," Mary Beth said. "But now it's worse."

"Worse in what way?" I asked.

She thought for a moment. "Well, I wouldn't have thought it possible, but I think I am feeling guilt over more things. I'm feeling a lot of guilt when I do some of the things we talk about in therapy."

"What kind of things?"

"Not even 'doing' things. I'm feeling guilty just because I am 'thinking' differently," Mary Beth said. "I can just think about standing up for myself to my mom --- something simple like not taking charge of our Thanksgiving extravaganza --- and here comes the guilt. There's no telling what it's going to feel like if I actually speak the word 'no' to her." Mary Beth laughed, but we both knew she was absolutely serious.

Mary Beth was not backsliding. She was just moving into some rough terrain on the road less traveled. She was beginning to encounter what my wife (an amazing therapist) calls "positive guilt." Positive guilt occurs when we begin to break rules that need to be broken, when we become aware of dysfunctional programming from our past and we develop the audacity to think for ourselves. For any of us who learned to get our self-esteem chips from denying ourselves and taking care of everyone else, positive guilt sets in when we refuse some of those chips and decide instead to consider what  – here comes the blasphemy – we want.

Positive guilt is like withdrawal pain for the addict. If I am an addict beginning to abstain from drugs, I will experience withdrawal physically and/or psychologically. For a while, the longer I refuse to use the drugs the withdrawal pain increases. The message of the withdrawal pain is simple: go back, go back where you were, where you came from, where you "belong."

Positive guilt conveys the same message to us. "How dare you stray from the tradition of this long-standing script! How dare you consider your own needs and wants! How dare you think for yourself!" the positive guilt screams. And if that doesn't work, it might tell us about how cruel we are and about how our "new and improved" behavior is going to hurt other people's feelings. And of course, part of the program tells us that if something we do hurts someone else's feelings then we are – bad.

I told Mary Beth about my wife's concept of positive guilt, and I told her that like the drug addict's withdrawal, it gets worse before it gets better.

"It's going to get worse?" she asked.

"Yes," I said, "but as long as you don't turn back, as long as you don't give into the addict's temptation to medicate the pain, it will get better – much, much better."

"Yeah, happy holidays to you too," Mary Beth said.