Heart patients with kids say that guilt motivates them to comply with doctors' orders.

I’ve never been a fan of the guilt trip.

My mother could fit a lifetime of disappointment and regret into a barely audible sigh. It was her way of letting her loved ones know we had failed her. (It was then up to us to guess how.) My mother learned this skill from her mother, whose sighs were a melodic downward trill concluding with a muttered Oy, Gutenu (Oh God, in Yiddish).

This early and frequent exposure to guilt trips has had the curious effect of making me both less and more susceptible to guilt. I can spot a guilt trip a mile away and I’ve developed a deflection shield. On the other hand, I also walk around carrying a vague sense that it’s all my fault and I should do better.

Either way, guilt doesn’t feel like my friend.

But in a recent study by cardiologists at the University of Pennsylvania Medical School, 65 of 100 heart patients reported that they were motivated by guilt to make healthy lifestyle changes; having kids had a lot to do with this. The researchers suggest that guilt could be a good motivational tool to get recalcitrant heart patients to clean up their acts.

Honestly, this was the first time it had ever occurred to me that guilt trips could  be used for good.

I rummaged around in some databases and found that for the most part, guilt isn’t a huge player in psychological literature. Freud thought it was the superego’s way of influencing the ego.  Some people insist that guilt is a solitary experience.  Arnold H. Buss wrote in 1980 that “Guilt is essentially private. The best test of guilt is whether anyone else knows of the transgression

Researchers struggle to tease apart the difference between shame and guilt. J. Gilligan, who studied violence, theorized that shame relates to the public embarrassment whereas guilt is an internal compass. I don’t know.  In ’94, the ever-interesting Dr. Roy Baumeister presented a solid argument for guilt as an interpersonal construct, saying it only exists in the context of relationships, even if it’s experienced in solitude. (Baumeister is also the guy who gave us words to douse our romantic torches, as discussed here.)

These days, researchers are talking about guilt as a motivational tool. One study finds that shame doesn’t stop people from substance abuse, while guilt does. That study defines shame as feeling bad about oneself and guilt as feeling bad about one’s behavior. And since your behavior inevitably affects other people, that view seems to support Baumeister’s relational theory.

Maybe guilt is interactive, and maybe it’s not such a bad thing. If feeling guilty about your kids motivates you to stay alive, what’s wrong with that?

And how about when parents make kids feel guilty? In a chapter titled “Inducing Guilt,” in the 1998 book  Guilt and Children, Baumeister tells parents that making kids feel guilty is OK.  He compares guilt to a knife or a hammer. “Such tools can cause considerable harm, especially when used in malicious or careless ways,” he wrote. “Still, the occasional harm should not blind us to the fact that guilt is frequently used in a proper and constructive fashion, with beneficial results.”

Judiciously applied guilt trips can help kids develop their moral compass, and they connect us in relationships; Baumeister and others have found that the single most common thing people feel guilty about, or try to make others feel guilty about, is neglect. A healthy sense of guilt makes us behave in ways that enhance our relationships, and “… only a fool would marry or hire someone who lacked an adequate sense of guilt,” Baumeister wrote.

And so Mom is vindicated. Her sighs built my character. And now I feel guilty about complaining.