We used to believe drilling a hole in your head was good for you (and we weren’t wrong)


In 1970, Joe Mellen injected a local anesthetic into the skin above his skull, pointed the 6mm bit of an electric drill at the position of his third-eye chakra and drilled a hole through his skull, careful not to go too deep and puncture the dura mater. The entire process took half an hour from start to finish, including clean-up. 

Like any reasonable person, you might ask yourself… Why? 

Mellen was inspired by Dr. Bart Hughes, a Dutchman and the founder of the modern trephination (trepanation) movement. Also known as auto-trephination or self-trephination, self-trephines drilled holes in their skulls to relieve pressure on the brain, allow blood to pulse freely within the cranium and return to a child-like state of being, or permanent high. And according to Mellen, it worked. Mellen went on to write “The Bore Hole,” inspiring hundreds of others to self-trephinate, although now he recommends seeking the help of a medical professional.

We recommend alternative methods to reach enlightenment and release your inhibitions. But Dr. Hughes wasn’t the first person compelled to drill a hole in his cranium. Were the self-trephines of the psychedelic golden age onto something? 

A rich history

The oldest-known trephined skull was discovered in Mesoamerica and dates from 950 to 1400 CE. Over 1,500 trephined skulls were discovered across North and South America, Europe, Africa, Polynesia and Asia. Five to ten percent of skulls discovered from the Neolithic period were trephined with one or more openings. 

Most civilizations abandoned the practice in the Middle Ages, but trephination experienced multiple resurgences throughout history. Historians refer to the 1700s as “trepan century” due to European surgeons’ renewed interest in drilling holes in skulls to treat mental illness and alter human behavior. The ultimate comeback kid made yet another resurgence during the Civil War due to the extremely high volume of head trauma experienced by soldiers. Evidence suggests that the practice was used well into the early 1900s in Africa and Polynesia to treat infection and trauma. 

You might be surprised by just how successful our ancestors were. In particular: the Incas. Far surpassing the survival rate of Civil War soldiers who underwent trephination (46-56 percent), a whopping 80 percent of Incas who underwent trephination survived the procedure. 

Scientists and historians hypothesize the Incas discovered a method of anesthetizing patients, likely derived from cocoa leaves, thus preventing shock and explaining their success. 

What motivated our early ancestors to undergo an unfathomably excruciating procedure, most often without anesthesia? They certainly didn’t see the trend on Instagram, and unlike the psychedelic self-trephines of the sixties and seventies, this was not an attempt to make an acid trip last forever. Geographically widespread evidence of Neolithic trephination tells us the practice developed in isolation across cultures. Much debate surrounds the motivation behind the procedure. Still, historians generally believe trephination was performed to free the possessed from evil spirits, for religious ceremonies and to relieve headaches and seizures (which were likely believed to indicate the presence of evil spirits).

This might be explained by neolithic humans’ inability to grasp the concept of death as an inevitable part of life, instead believing that death was provoked by the supernatural, and therefore, could be stopped.

Why the skull?

Our early ancestors might have observed that head injuries result in comas, interpreted the comatose state as death and the awakening from a comatose state as becoming undead. They drew the conclusion that whatever evil spirit entered the head through injury could also be released through trephination.

Enter: modern neurosurgery. 

Hundreds of thousands of craniotomies, a surgery to cut an opening into the skull, are performed each year, saving hundreds of thousands of lives. Craniotomies allow surgeons to access the brain for a variety of purposes including: 

  • Inserting a shunt to drain cerebrospinal fluid
  • Inserting a deep brain stimulator (DBS)
  • Inserting an intracranial pressure (ICP) monitor 
  • Removing a sample of tissue (needle biopsy)
  • Draining blood 
  • Inserting an endoscope to remove a tumor
  • Treating aneurysms

Like our ancestors, some craniotomies are even performed on conscious patients, when a lesion is close to critical areas of speech. The patient is asleep for the bone removal and then awakened and prompted to speak, allowing the surgeon to map the at-risk area. 

Sound familiar? 

Our neolithic ancestors paved the way for modern neurosurgery to flourish. We can’t deny how truly impressive these ancient civilizations’ use of trephination was. We also can’t separate our ancestors’ spiritual motivations from their desire to treat the medical conditions we know today (chronic headaches, epilepsy, mental illness and more) because they were likely perceived to be one and the same. As medicine continues to move forward, we continue to learn from our ancestors by looking back.


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