Driller thriller: A beginner’s guide to voluntary trepanning‬

Back when I first joined Nottingham Trent University in 1995, one of my colleagues (and now good friend) Phil Banyard introduced me to a book called the Amok Journal: A Compendium of Psycho-physiological Investigations edited by Stuart Swezey (and is quite possibly the best non-fiction book I’ve ever read). Not only has it got some great articles on sexual paraphilias, it was the book that introduced me to voluntary trepanning (drilling a hole through your own skull to feel psychologically better). Before looking at voluntary trepanning, it should be remembered that trepanning for genuine medical complaints has long been practiced.

In medical circles, trepanning (sometimes referred to as trephination or trephining) involves the making a ‘burr hole’ in the skull. Surgical burr holes are usually made by brain surgeons on the human skull or cranium to facilitate surgery (e.g., to drain a haematomas on the brain, or to relieve intra-cranial pressure). Surgeons nowadays are more likely to refer to this procedure as a craniotomy. A trephine is the instrument that is actually used for cutting out a disc-shaped piece of skull bone. According to a 2009 report in the New Scientist by Arran Frood, there is research being undertaken that is looking at the possible benefits of trepanning for those with Alzheimer’s Disease. Frood reported:

“In the early 1960s, a young Russian neurophysiologist called Yuri Moskalenko travelled from the Soviet Union to the UK on a Royal Society exchange programme. During his stay, he co-authored a paper published in Nature. ‘Variation in blood volume and oxygen availability in the human brain’ may not sound subversive, but it was the start of a radical idea. Decades later, having worked in Soviet Russia and become president of the Sechenov Institute of Evolutionary Physiology and Biochemistry at the Russian Academy of Sciences in St Petersburg, Moskalenko is back in the UK. Now collaborating with researchers at the Beckley Foundation in Oxford, his work is bearing fruit. And strange fruit it is. With funding from the foundation, he is exploring the idea that people with Alzheimer’s disease could be treated by drilling a hole in their skull”.

Trepanning has been carried out among humans since prehistoric times as a way of treating various medical conditions (e.g., severe head wounds, mental disorders, epileptic seizures, bad migraine headaches, etc.). The Wikipedia entry on trepanning claims:

“Trepanation is perhaps the oldest surgical procedure for which there is archaeological evidence, and in some areas may have been quite widespread. Out of 120 prehistoric skulls found at one burial site in France dated to 6500 BC, 40 had trepanation holes. Many prehistoric and pre-modern patients had signs of their skull structure healing, suggesting that many of those subjected to the surgery survived”

There is also an abundance of archeological evidence from unearthed skulls that trepanning was carried out in pre-Columbian Mesoamerica (such as the tribes in Monte Albán), among New World societies (e.g., pre-Incan cultures in Andean civilizations, the Peruvian Ica tribes, etc.), Mexixo (including Tarahumara tribes in north-west Mexico, and Oaxaca tribes in southern Mexico). However, archeologists have been quick to note that skull modification and skull mutilation (i.e., the fashioning of ‘trophy skulls’ from enemies for ritualistic displays) were often carried out post-mortem by some peoples that makes trepanning harder to detect and/or confirm. The Wikipedia entry also notes that a study of ten low-status burials from the Monte Albán region concluded that:

“Trepanation had been applied non-therapeutically, and, since multiple techniques had been used and since some people had received more than one trepanation, concluded it had been done experimentally. Inferring the events to represent experiments on people until they died, the study interpreted that use of trepanation as an indicator of the stressful sociopolitical climate that not long thereafter resulted in the abandonment of Monte Alban as the primary regional administrative center in the Oaxacan highlands”

As outlined above, trepanning is usually done for medical reasons but in extreme cases, trepanning may be carried out by healthy individuals who believe they will experience a variety of physical and/or psychological benefits. Such acts of voluntary trepanation are considered to be pseudoscience but that hasn’t stopped the practice among a minority of adherents who claim that it is helpful in treatment for conditions such as depression and chronic fatigue syndrome (although there is no scientific support for this as far as I am aware).

Two of the most proactive voices in the trepanning field are Peter Halvorsen (who runs the International Trepanation Advocacy Group) and Bart Huges (who wrote the 1962 monograph Homo Sapiens Correctus that advocated the benefits of self-trepanation). Both Halvorson and Huges practiced what they preached and drilled a hole into their own skulls to increase ‘brain blood volume’ (that according to adherents enhances cerebral metabolism in a manner similar to cerebral vasodilators that widen blood vessels). However, having tried to look for academic papers, I haven’t found peer reviewed papers that support the claims in relation to self-trepanation in healthy individuals. Halvorsen’s website has access to a scientific paper he co-authored and published in a 2008 issue the journal Human Physiology. The authors claim that the study (to their knowledge) is “one of the first fundamental physiological studies on craniotomy”. They reported that:

“The sample comprised 11 patients of a neurosurgical clinic in whom a trephine opening in the cranial bones was made for medical indications…We recorded pulse changes in blood circulation (by transcranial Doppler sonography) and in the ratio between the pulse fluctuations in the blood and CSF volumes (by rheoencephalography) before and after surgery…After craniotomy, the cross-flow of CSF between the cranial and spinal cavities decreased significantly, giving way to volumetric compensatory translocations of blood and CSF within the cranial cavity per se during the cardiac cycle, which increased the intracranial utilization of the energy of the cardiac output and con- tributed to the outflow of venous blood from the cranium. The results suggest a beneficial effect of craniotomy on the physiological mechanisms of the circulatory and metabolic maintenance of the brain activity”.

Although this medical paper shows support for the medical benefits of trepanation, the study was carried out on those who needed medical treatment, not those who were healthy. One of the claims often made is that children (whose skulls are not filly closed) have “a higher state of consciousness” and that self-trepanation helps adults return to their prior child-like state (however, I can find no academic research to support the idea that children have a ‘higher state of consciousness’ or how ‘higher state’ in this context is defined).

Arguably the most infamous account of trepanning was that written by Joseph Mellen in his 1975 book Bore Hole (although it’s actually more of a booklet). His partner (Amanda Fielding, a friend of Mick Jagger) also underwent a trepanation procedure (that Mellen filmed for the documentary Heartbeat in the Brain, parts of which appear in the film A Hole in the Head). Mellen had tried a couple of times to drill a hole through his skull but it wasn’t until a third attempt that it was deemed by Mellen as an ‘enlightened state’. In his won words, Mellen wrote:

“After some time there was an ominous sounding schlurp and the sound of bubbling. I drew the trepan out and the gurgling continued. It sounded like air bubbles running under the skull as they were pressed out. I looked at the trepan and there was a bit of bone in it. At last!”

Having tried to read as much on the topic as I can, I have to agree with the conclusions of another online essay about trepanning which said the practice is “unproved, archaic, and even laughable to modern medical thinking, the science of trepination will continue to the hold the fascination of the open-minded, as it has through human history”

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Mellen, J. (1975). Bore Hole. London: Glucrocacy.

Moskalenko, Y.E., Weinstein, G.B., Kravchenko, T.I., Mozhaev, S.V., Semernya, V.N., Feilding, A., Halvorson, P., & S. V. Medvedev, S.V. (2008). The effect of craniotomy on the intracranial hemodynamics and cerebrospinal fluid dynamics in humans. Human Physiology, 34, 299-305.

Swezey, S. (Ed.) (1995). The Amok Journal: A Compendium of Psycho-physiological Investigations. Los Angeles: Amok.

Frood, A. (2009). Like a hole in the head: The return of trepanation. New Scientist, June 17. Located at: http://www.newscientist.com/article/mg20227121.400-like-a-hole-in-the-head-the-return-of-trepanation.html?full=true

Kook Science Resistance (2010). I drilled a hole into my head. Located at: http://www.kookscience.com/2010/i-drilled-a-hole-in-my-head/

About drmarkgriffiths

Professor MARK GRIFFITHS, BSc, PhD, CPsychol, PGDipHE, FBPsS, FRSA, AcSS. Dr. Mark Griffiths is a Chartered Psychologist and Distinguished Professor of Behavioural Addiction at the Nottingham Trent University, and Director of the International Gaming Research Unit. He is internationally known for his work into gambling and gaming addictions and has won many awards including the American 1994 John Rosecrance Research Prize for “outstanding scholarly contributions to the field of gambling research”, the 1998 European CELEJ Prize for best paper on gambling, the 2003 Canadian International Excellence Award for “outstanding contributions to the prevention of problem gambling and the practice of responsible gambling” and a North American 2006 Lifetime Achievement Award For Contributions To The Field Of Youth Gambling “in recognition of his dedication, leadership, and pioneering contributions to the field of youth gambling”. In 2013, he was given the Lifetime Research Award from the US National Council on Problem Gambling. He has published over 710 research papers, five books, over 150 book chapters, and over 1500 other articles. He has served on numerous national and international committees (e.g. BPS Council, BPS Social Psychology Section, Society for the Study of Gambling, Gamblers Anonymous General Services Board, National Council on Gambling etc.) and is a former National Chair of Gamcare. He also does a lot of freelance journalism and has appeared on over 3000 radio and television programmes since 1988. In 2004 he was awarded the Joseph Lister Prize for Social Sciences by the British Association for the Advancement of Science for being one of the UK’s “outstanding scientific communicators”. His awards also include the 2006 Excellence in the Teaching of Psychology Award by the British Psychological Society and the British Psychological Society Fellowship Award for “exceptional contributions to psychology”.

Posted on February 21, 2013, in Case Studies, Mania, Obsession, Popular Culture, Psychiatry, Psychology and tagged , , , , , , , , , . Bookmark the permalink. Leave a comment.

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