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First, I wish to thank all the commentators for their thoughtful comments. Given the controversial nature of the hypothesis I have presented, I fully expected some lively debate on the subject—and I think we have that.
Georg Northoff contrasts a “localization-based approach to the brain” with a “mechanism- and coding-based approach” that operates across various regions. The latter emphasizes networks, including the default-mode network that modulates the brain's resting-state activity. He suggests that specific defense mechanisms may correspond to specific principles of neuronal integration and that since these represent complex emotional-cognitive interactions, they cannot be localized in specialized or segregated brain regions. I would agree with Northoff on this point. My general theory supposes that in the intact brain state, the appropriate right-hemisphere-left-hemisphere interactions create the circumstances for the inhibition of the immature defenses and the emergence of the mature defenses. It goes without saying that all defense mechanisms must surely engage local as well as remote brain regions, and my hypothesis leaves open the question of, for example, the role of cortical-subcortical interactions in the mobilization of any defense. One part of my theory is that the neuroanatomical data indicate that for certain defenses, there appears to be a right- hemisphere-left-hemisphere difference in lesion localization that corresponds to the maturity versus immaturity of the defense. This finding leaves open the broader question of the nature of the extensive neural network(s) that must be activated for a complex defense to be activated. I agree with Northoff that these approaches are complementary rather than contradictory.
I appreciate David Roane's observation that “when changes in the brain affect function, the adaptive or emotional responses to that change cannot be fully separated from the change itself.” This is a succinct summary of one of the most neglec