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The aim of this paper is to explore the theoretical and clinical features of burdening guilt according to control-mastery theory (CMT), an integrative, relational cognitive-dynamic theory of mental functioning, psychopathology, and psychotherapy. CMT posits that burdening guilt stems from the belief that one’s emotions, needs, and way of being are a burden to significant others. After having introduced some research data about the belief of being a burden to others, we will point out how CMT explains this belief in light of a coherent theory of development, emphasizing its connection with early traumatic or adverse experiences with caregivers that give rise to the formation of pathogenic beliefs. These beliefs are mostly unconscious, and influence the way people make sense of themselves and their reality, giving rise to symptoms, inhibitions, and maladaptive personality traits that obstruct the achievement of healthy and adaptive goals. We will then compare burdening guilt with omnipotent responsibility guilt and self-hate, highlighting the points of contact and the differences between these types of interpersonal guilt. Subsequently, we will point out the “double nature” of burdening guilt, describing how it represents both a self-blame for what one is, and the expression of the need to take care of important others. Finally, we will propose a clinical vignette to illustrate some manifestations of burdening guilt in the therapeutic context.