Thus, Dr. Salzman is highlighting the existence of a third group of patients—mild outpatient cases of borderline personality disorder with no history of psychiatric hospitalization. In our clinical experience, patients with the diagnosis of borderline personality disorder who have never been hospitalized lack the impulsivity of those patients who have been inpatients, since patients with borderline personality disorder are typically hospitalized for their own protection during periods of intense self-destructiveness. This raises the question of whether "borderline" patients who have never been hospitalized are, in fact, borderline at all or whether they should be considered patients with borderline traits or features. To phrase the question another way: should nonimpulsive patients who manifest the intense dysphoria, suspiciousness and dissociation, and difficult, stormy relationships characteristic of borderline personality disorder be considered borderline? Should someone without a history of deliberate physical self-harm, help-seeking suicidal efforts, or both be thought of as a borderline patient?