Trepanation

Domain XVI · Historical, discredited & harmful

What it is

Trepanation (also trephination) is the deliberate opening of a hole in the living skull; a 2001 news report on an unlicensed operation in Utah called it "skull drilling". André describes it as one of the oldest surgical practices, dating back roughly 7,000 to 10,000 years and documented in Europe,…

Format

• Classical medicine. The Hippocratic On Injuries of the Head deals with scalp wounds, fractures and contusions of the skull, and considers trepanning for serious, possibly hidden fractures after a forceful blow with signs such as dizziness, stupor or collapse. Adams, in his 1886 edition, comments…
• Pace and number of sessions are set by risk and the client's needs.

Who practises it, and how they are trained or regulated

• Modern revival (1960s onward). A Dutch advocate, Hugo Bart Huges, circulated a manuscript in 1962 claiming trepanation would permanently raise brain blood volume and consciousness and trepanned himself in 1965; early followers included Amanda Feilding, who later stood twice for the UK Parliament on a platform including public funding for trepanation. Peter Halvorson founded the International Trepanation Advocacy…
• Trepanation (also trephination) is the deliberate opening of a hole in the living skull; a 2001 news report on an unlicensed operation in Utah called it "skull drilling". André describes it as one of the oldest surgical practices, dating back roughly 7,000 to 10,000 years and documented in Europe, Africa, Asia and the Americas. Historians and archaeologists identify head injury as a main reason; ritual or religious…

Evidence status, as the guide reports it

• Psychoeducation, meaning and alternatives. Goal: give the evidence status in plain terms, work with the needs behind the interest, and agree safe alternatives. Move on when the client's plan no longer includes the practice.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• missed follow-up after a crisis appears to settle.
• the trip being kept from family; pressure from organisers.
• dismissing faith; or, at the other extreme, missing psychosis.
• pressure to stay quiet; your own reluctance to report a friend.
• family conflict pushing the person toward the group; carer burnout.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.