Defense and coping in the antinomy between self-maintenance and adaptation.

After definitions of the terms defense and coping, the disturbances of both linked to narcissistic personality disorders, borderline personality disorders, and major depressions are described. All three are characterized by deficient narcissism. In narcissistic personality disorders, defense and coping are hindered mainly because of a lack of narcissistic investment of the ego, in borderline personality disorders preponderantly because of a fragmentation-prone ego with its rigid defenses, and in major depressions primarily because narcissistic emptiness or depletion breaks down interest of the ego to get along with the environment or leads to an extreme overinvestment of the remaining narcissism in the objects. Finally, the three levels of object relations--the narcissistic--fusionary one, the level of active ego performances, and the level of free decisions--and their functioning with respect to coping in the three disorders mentioned are discussed.