Green’s Dictionary of Slang

hole in one’s head n.

1. (US) a lack of common sense; note attrib. use in cit. 1993.

[US]Des Moines Register (IA) 6 Mar. 14/4: One who is a little slow mentally [...] may have ‘holes in the head’.
[US]T. Heggen Mister Roberts 47: You’ve got holes in your head if you get rid of the only dose of clap.
[US]J.D. Salinger Catcher in the Rye (1958) 104: They [the Disciples] were all right after Jesus was dead and all, but while He was alive, they were about as much use to Him as a hole in the head.
[US]S. Bellow Augie March (1996) 417: I reflected [...] that I must have holes in my head like a colander not to refuse.
[Aus]M.B. ‘Chopper’ Read How to Shoot Friends 84: I too will join the world of the crims turned charity workers. I will open the ‘Hole In The Head Home For Old Ratbags’.

2. nonsense, lies.

[US]‘Ed Lacy’ Men from the Boys (1967) 30: ‘It could be an ulcer, an inflated stomach, a hundred and one things besides ...’ ‘Don’t talk a hole in my head, Art!’.

SE in slang uses

In phrases

need like a hole in the head (v.) (also need like a third nut) [joc. use of SE but note Yid. ich darf es vi a loch in kop, ‘I need that like a hole in the head’]

to not need at all.

[US]A. Kober Parm Me 7: A badhouse? I need it like I need a hole in the head.
[US]B. Schulberg Harder They Fall (1971) 210: This is just what we needed, like a hole in the head.
[Aus]‘Geoffrey Tolhurst’ Flat 4 King’s Cross (1966) 24: Whatever Mr. Nicholas wanted, he wanted like a hole in his head a phone call from a girl to his house on a Sunday morning.
[US]Mad mag. Spring 8: This television personality [...] needs our plugs like a hole in the head.
[US]K. Marlowe Mr Madam (1967) 159: I’m sick and tired of him. I need him like a hole in the head.
[US]J. Lahr Hot to Trot 209: ‘I need this like a hole in the head,’ Mom says.
[US]R. Price Blood Brothers 118: Then he asks me if I want more grass. [...] More grass I need like a third nut, you know?
[UK]F. Taylor Auf Wiedersehen Pet Two 75: At that moment Ally Fraser needed interest from conservationists like he needed the proverbial hole in the head.
[Aus]M. Bail Holden’s Performance (1989) 288: In this business I need a name like, I don’t know – a hole in the head.
Whitehead & Moodley Transforming Managers 210: But we and they need this sort of crap like a hole in the head.
in M. Kefalas Working-Class Heroes 134: We need more taxes like a hole in the head.