Self-trepanation seems the realm of low budget horror films and historic medical literature. However Neurophilosophy has a transcript of an interview with a recent self-trepanner.
M: How exactly did you perform the trepanation?
HP: I used a hand trepan initially, but that wasn’t proving to be terribly successful. Then there was a problem with the people who owned the property we were staying in, so we decided we’d have to just leave it. I wrapped my head up in a towel and we got out of there. A couple of days later, we had another go. We abandoned the hand trepan and got an electric drill instead. I injected myself with a local anaesthetic and then slashed a big T-shaped incision in my scalp, right down to the bone. I was sat there in the bathroom feeling quite relaxed and they started with the drill.
via Mind Hacks