Saturday, October 31, 2009

Last Tour, Royal Burgh of Culross

Entry for 31 October 2009:


Many Historic Scotland or National Trust for Scotland properties close for the Winter, often on the 1st of November. Therefore, for the Samhain (or Halloween) edition of our Saturday Adventure, we looked for something that was both within driving distance and about to close for the season. The Royal Burgh of Culross (pronounced Coo’rus) , on the north shore of the Firth of Forth, past the Kincardine Bridge, a few miles into Fife, fit the bill.


We arrived about 1 in the afternoon. The day was mixed cloud and sun, but not as rainy as it has been lately. With the intervention of the National Trust for Scotland, much of the old town has been charmingly saved from destruction, restored and preserved. Amazingly, quite a bit remains from its heyday in the early 17th century, when it was a centre for industry and trade.


The central attraction is the “Palace”, a rambling set of yellow-coloured buildings constructed by George Bruce, a wealthy merchant and essentially the founder of the British coal mining industry. There was a deep seam of coal under Culross, extending out into the Firth of Forth, and Bruce create a coal mine (known in the UK as a colliery) under the water, using what was then new technology (tall coffer dam to keep the water out, and early conveyor belt system of buckets to drain the mine). This also enabled him to harvest sea salt from the water of the Firth of Forth using a large number of “salt pans”. He was friends with King James the first of Britain (who was King James the Sixth of Scotland), and so got Culross made into an international trading port. He was then able to trade coal and salt to England and the Netherlands, and became very wealthy as a result.


Culross also developed an iron industry of “hammermen”, famous for making the round iron “girdles” used for cooking the Scottish national staple: oatcakes. “Girdle” is the Scots word for “griddle”. “So that’s how they do that!”, we exclaimed.


We were amazed by the Palace, wandering through room after room, the original wooden, barrel-vaulted ceilings of many of the rooms, original painted decorations still visible in many places; other rooms refitted a century later in Georgian style; the quaint needlework examples throughout; the extensive organic herb garden out back; the knowledgeable guides.


After wandering through the house and garden for a couple of hours, we caught the 3pm tour of the other NTS properties in Culross, the last tour of the day, and therefore the last tour of the season. And old gentleman, with the air of a former school teacher, entertained us with stories and information about the history of Culross and especially two of its most famous citizens: George Bruce, already mentioned, and Thomas Cochrane, naval hero and model for several fictional ship’s captains, including Horatio Hornblower.


Most entertainly, he took us up an old cobblestone lane, named Back Causeway (”Causey” in Scots). He carefully and vividly explained to us that we had the choice of walking along the side of the Causey, where the miners and other ordinary folk walked amid the waste and offal :“sleugh” (“gutter” in American English; but see my September 2009 entry on “Slough”); or alternatively we could walk on the higher middle part, where the wealthy people went: the “croon of the causey”. Actually, the footing was surer in the sleugh and it was easier to get out of the way of the occasional car trying squeeze its way through the narrow lane.


Afterwards, we had a very nice meal at the Red Lion Inn, before heading back to Glasgow. It was a lovely alternative way to spend the last day of Celtic summer (Samhain), and an excellent pick of a seasonal historic site.

Sunday, October 25, 2009

Good Night, Uncle Lester

Entry for 24 October 2009:


Lester Luborsky died this week. He was one of the great psychotherapy researchers, and one of my personal psychotherapy research heroes. For me, his passing leaves a world that feels smaller.


At the moment, I can’t remember exactly when I first met Lester. Probably at my first SPR meeting in San Diego in 1976. Of course, I would have been too shy to introduce myself to him then. Later, I came to know him, not as well as I eventually knew Han Strupp, the other comparable titan of psychotherapy research, but nevertheless with a great deal of fondness and as an essential fixture in that world.

Lester made a great many contributions to psychotherapy research, and had a big impact on my development as a psychotherapy researcher. Here are a few of these:


1. Along with Ed Bordin, he pioneered the modern concept of the therapeutic alliance (which he called the “helping alliance`”). Unlike others who began working on this topic in the 1970’s, he was careful to credit the influence and seminal work of Carl Rogers, even though his theoretical orientation was psychodynamic. I loved his “counting signs” approach to looking for spontaneous client alliance markers at the beginnings and endings of sessions. (A personal favorite, which I quoted to my students again recently: Client [weeping]: “I’m not getting better… and you’re getting worse.”)


2. His development of the Core Conflictual Relationship Method (CCRT) made the Freudian concept of transference available to all of us in a theory-neutral, user-friendly form. I found CCRTs essential for understanding significant change events, and incorporated the method into my Comprehensive Process Analysis method.


3. Lester’s development of the Symptom Context Method might have been one of his more obscure contributions, but for me it was a key inspiration for the development of the Significant Events genre of therapy research. Although he focused on client in-session manifestations of psychodynamic or clinical symptoms (e.g., momentary forgetting), it was easy to apply to his approach of comparing session transcripts immediately before and after targeted therapy events to moments of therapeutic change.


4. When it came to understanding the broad sweep of comparative therapy outcome research, Bill Stiles, David Shapiro, and I, along with others, followed in Lester’s footsteps: He picked up the analogy between the Dodo Bird’s verdict in Lewis Carol’s Alice in Wonderland and the state of comparative outcome research (“Everybody has won and all must have prizes”) from Saul Rosenzweig, and we picked it up from Lester. Later, he took Jeff Berman’s work on researcher allegiance and in 1999 did the definitive meta-analytic study showing that virtually all the available variance in comparative outcome studies can be attributed to researcher allegiance effects (that is, when comparing active therapies, researchers tend to find results favoring their approach to therapy).


5. He also wrote one of the first therapy manuals, in the early 1980’s, describing a simplified psychodynamic approach he called supportive-expressive therapy. “Oh!”, some of us said, “You mean it’s possible to write a manual for a nonCBT therapy?” And so we did…


6. Most important for me, however, was Lester’s creative, can-do genius for inventing methods for particular purposes, jury-rigging if necessary, but basically saying, "What can I do with the data I have to answer that question, or to address that doubt about what’s going on here?" His example has inspired me throughout my career to think creatively about method.


Others will undoubtedly have their own lists of favorite Lester contributions to add to these, for he did many other things than I can even remember at this point. For example, not many people know that he originated Axis 5 of the DSM-IV, now known as the Global Assessment of Functioning (only his original version was better than what eventually got into the book).


In the end, though, what I remember Lester most and best for is simply his presence: The tall, thin, slightly eccentric figure he presented (often carrying a special pillow for his back); his elfin smile as he presented some clever way of showing something. Generally, he was usually there, a presence slightly in the background, not in the front but back a bit, and always ready to point something out if he felt it needed to be.


I always found his to be a kind presence, friendly and supportive. He followed my work, wrote letters supporting my tenure and promotion. In 1993, at the first North American SPR meeting, I had to say something official, and found myself comparing SPR to a family, complete with brothers, sisters, cousins, parents, grandparents, aunts and uncles. Afterwards, I sat up late talking in one of the lounge areas, as one does at conferences. Lester wandered by, and I felt what could only be described as a wave of love washing over me; I found myself saying, “Goodnight, Uncle Lester.” For that is exactly what Lester Luborsky felt like to me: a slightly eccentric but totally inspiring uncle (probably on my mother’s side), the kind who is always having adventures and inventing things. He was my hero.

Friday, October 09, 2009

Pluralism as a Movement from Tribalism to the Cosmopolitan Spirit

Entry for 9 October 2009:


Quick trip down to Newcastle after intense three days: The new Fulltime Counselling Diploma course started, more restructuring discussions; discussions with Beth about the empathy scale we are working on; meetings with research students; client work; an EFT-3 session on anxiety splits. Yesterday (Thursday), I got up early and caught the 6.31 train from Hyndland to Queen Street. There I managed to get on the 6.45 to Edinburgh, where I ran into M, also heading for Newcastle; we met up with John McLeod at Edinburgh Waverly and continued on from there on the East Coast Line. We immediately fell into a series of engrossing conversations on various topics: Science fiction for starters: I discovered that John is an old sf fan when he spotted the issue of Fantasy and Science Fiction, and said, “I read that when I was a kid; I didn’t know that they still published it!.


The conversation soon turned to the future of counseling in the UK; John and M think that what they call Collaborative Pluralism -- which they are writing a book about -- is The Way Forward. (Note: I suggested the phrase “Collaborative Pluralism” to them as a conference in Dundee in 2007; it’s really nice to see that they have picked it up for the approach they are elaborating.)


As they talked, a thought came to me and I pointed out that there is nothing new about either the warring therapeutic factions they are trying to surpass or the pluralistic alternative: From a deep cultural-historical point of view, the feuding approaches to therapy, and even what gets labeled as “modernism” (indeed all “isms”) are all forms of tribalism, organized around key beliefs, which in the modern world take the place of the old tribal gods.


The contrasting attitude of tolerance and appreciation also go way back: accepting the inevitability and even the desirability of multiple value systems bringing multiple views of the world and human events. Such as attitude first emerged in large multicultural cities in the ancient world, often located at meeting points or nexus points for multiple trading routes, for example, Alexandria. The world view and life style that such cities gave rise to was referred to as “cosmopolitian”, from polis = city, plus cosmos = universe, that is, the culture of cities encompassing all or almost all of the known human universe (“universal cities”). Thus, the ancient cultural-historical distinction that John and M are working from is between the tribal and the cosmopolitan. An important aspect of cosmopolitan cities is that they contain a mixture of people. On the one hand, there are people who have been in the city for many generations and are therefore now native to it; such people tend to develop a syncretic, tolerant, pluralistic world view. On the other hand, there are people who have newly arrived to the city from a variety of different traditional cultures in the provinces or more distant parts of the empire or known world; these folks are therefore still to varying degrees tribal in their outlook and culture. Thus, an important aspect of being cosmopolitan is being able to deal effectively with folk who are still partly tribal in their culture, and not just other enlightened, sophisticated folk.


Thus, I argued, pluralism in its different forms, including John and M’s collaborative pluralism, is really a modern expression of the ancient tendency for people in large, cross-roads-type cities to develop a tolerant, nondefensive and curious way of living with and appreciating the diversity of people with whom they come in contact. It’s my view that cosmopolitan/pluralistic cities enable people to access one of the great forces in human history, namely, a kind of cultural self-actualization that drives the development of trade, knowledge, and most importantly, the broadening out of the human spirit and the cultivation of a deep appreciation for human difference. This attitude of tolerant acceptance is at the root of the Person-Centred Approach in its broadest (and I think most true) form, but also in Process-Experiential/Emotion-Focused Therapy, and in John & M’s Collaborative Pluralism.


The ensuing conversation covered this but much more beside; so engrossed were we that we almost missed our stop at Newcastle. It’s sad that it’s not possible to have conversations like this more regularly!

Tuesday, October 06, 2009

aHSCED study finally published: Elliott et al. (2009)

Entry for 4 October 2009:


Reference: Elliott, R., Partyka, R., Wagner, J., Alperin, R. & Dobrenski. R., Messer, S.B., Watson, J.C. & Castonguay, L.G. (2009). An Adjudicated Hermeneutic Single-Case Efficacy Design of Experiential Therapy for Panic/Phobia. Psychotherapy Research, 19, 543-557. [Appendices available at: http://www.informaworld.com/smpp/content~content=a914761426~db=all~tab=multimedia]


Commentary: In developing the Hermeneutic Single Case Efficacy Design (HSCED) method, my students and I at Toledo experimented with various research strategies. The first published HSCED study (Elliott, 2004) was my SPR Presidential Address paper, and was based on the idea that the method could be carried out by single therapists with their own clients. This model of HSCED research still makes some sense to me, but is regarded with suspicion in the Person-centred community in the UK, because of the dual relationship issues. (Incidentally, this is an argument that has never held much water for me, because of the long history of narrative case studies, the great prepounderance of which were therapists written about their own clients. This particular squeamishness seems to come out of general distrust and alienation between research and practice.)


In any case, my team at Toledo also experimented early on with doing case comparisons (which we presented at the 1999 SPR conference in Chicago): These proved unwieldy and were replaced by single-case case studies. Next, inspired by Art Bohart and Carol Humphreys, we began experimenting with a legalistic or adjudicated case study model, built around the HSCED framework of types of evidence and alternative explanations or validity threats. The first of these cases was planned in 2000, even before I gave SPR Presidential Address at the SPR conference in Montevideo, Uruguay. A client came to the Center for the Study of Experiential Psychotherapy (CSEP) suffering from severe anxiety difficulties with panic episodes associated with crossing bridges and heights. He was an older gentleman, had had an earlier unsuccessful CBT treatment for these problems, and looked to the research team to be a challenging case. At the same time, I’d been doing meta-analytic research that pointed to the possibility that person-centred-experiential (PCE)) therapy might be less effective with anxiety problems.

As a result, we assigned this client, whom we eventually renamed as “George”, to me. Although I’d worked with PTSD quite a bit, I hadn’t worked with panic difficulties very much, so I did some reading on experiential approaches to panic difficulties and got a bit of consultation from Barry Wolfe, who done some work on the topic and whom I ran into at a meeting. Rhea Partyka coordinated the study and was the researcher who interviewed George.


I began seeing George, with a fair amount of trepidation: Could George and I find a way of working together that would enable him to overcome his severe anxiety difficulties in a time-limited (up to 40 sessions) therapy? Or had I bitten off more than I could chew?


Fortunately, George and I hit it off really well, worked hard, and after 23 sessions, George, with no pressure from me, felt satisfied with his progress enough to declare himself finished with therapy. At this point, the research team began organizing the adjudication process: We lined up three judges from well-known psychotherapy researchers, each representing a different theoretical orientation: Stan Messer (psychodynamic), Jeanne Watson (humanistic), and Louis Castonguay (cognitive-behavioral). We assembled two teams of two postgrad clinical psychology students each, an affirmative team (Rhea Partyka and Becky Alperin) to argue the case in favor of George having changed and for therapy having been responsible for George’s having changed; and a sceptic team (John Wagner and Rob Dobrenski) to argue the opposite. Rhea and I put together a set of documents summarizing the process and outcome of the therapy and agreed to by affirmative and sceptic teams. Then affirmative sceptic teams each wrote briefs and offered rebuttals to each other’s cases. All of this was sent off to our three judges, who each had instructions to render verdicts on the two questions of client change and the contribution of therapy to possible client change.


What did the judges rule? See the Abstract below, or better yet go look up the article and the Appendix that contains all the case documents, including the judges’ commentaries.


All this sounds fairly straightforward; however, it proved to be challenging to write up this study for publication and to deal with the editorial feedback. First, it took me two years to get it written up and submitted. Our original idea was that it would be published as a suite of three papers: (a) Paper describing the case method and summarizing the Rich Case Record and Affirmative and Sceptic Briefs and Rebuttals (U of Toledo team as co-authors); (b) judging procedure and judges’ opinions (judges as authors); and (c) follow-up data, and general discussion (Elliott & Partyka as co-authors). I submitted this unusual package to Psychotherapy Research, under Bill Stiles’ editorship; Bill gave us a revise and resubmit verdict asking us to combine all this into a single paper. And there the paper sat for 5 years, aside from a couple of false starts, until a year ago, when I began my 20-minute a day writing regime. This was what finally enabled me to gain momentum on the revision, so that when 4 days for writing suddenly opened up in early January of this year, I was able to finish the revisions and resubmit. My co-authors were delighted to see the thing moving again after the long delay, and even more so to see it finally appear in print.


One of the technical challenges of publishing HSCED studies is what to do with the extensive documentation, in this Rich Case Record, Briefs, Rebuttals, and Judges’ Opinions. In this case, that puzzled has been dealt with by publishing these materials online, on the journal’s website.


Abstract

This paper illustrates the application of an adjudicated form of Hermeneutic Single Case Efficacy Design (HSCED), a critical-reflective method for inferring change and therapeutic influence in single therapy cases. The client was a 61 year-old European-American male diagnosed with panic and bridge phobia. He was seen for 23 sessions of individual Process-Experiential/Emotion-Focused Therapy. In this study, affirmative and skeptic teams of researchers developed opposing arguments regarding whether the client changed over therapy and whether therapy was responsible for these changes. Three judges representing different theoretical orientations then assessed data and arguments, rendering judgments in favor of the affirmative side. We discuss clinical implications and recommendations for the future interpretive case study research.

Sunday, October 04, 2009

EFT-1a Training in Groningen

Entry for 4 Oct 2009:


In and out of the bright Sunday morning sun, dozing after an intense two days of EFT training in Groningen, the brightness surprising me, after the autumn rains, just as the sudden moon shining between the clouds startled and pleased me last night as I walked back from Renate and Andries’ flat after a full evening of conversation and food. (The moon shone in on my bed all night, keeping me company far from home.)


Last May, after I did a 1-day EFT taster course near Utrecht, we decided to move toward creating ongoing EFT training in the Netherlands; we started the process by restructuring the October 2-day Introductory EFT workshop into the first part of a Level 1 training. Subsequently, one of the people involved in this, Juliet, came over to Glasgow in July for the annual EFT-1 that Jeanne and I have been running.


This weekend was the first step in this process, and I think was quite successful, fully booked, with 25 enthusiastic participants. It took place in a music studio, a bit north of the city centre of Groningen, a university town in the northern part of the Netherlands. The participants were Dutch psychotherapists from varying professions, with a predominance of psychologists, most of them highly experienced. Some were researchers or trainers, and a couple were already teaching EFT. This made it a highly knowledgeable but genuinely curious audience, with many useful questions.


To bring this off, the main thing I did was to move the Research Summary from the end of Day 4 to the end of Day 2. Jeanne and I had already added Focusing-based exercises to go with the emotion theory input and moved Empty Chair Work in front of Two Chair. This meant that Focusing got prominent play the first day and Two Chair Work was pushed into the second part of EFT-1, making it the main task there. All of these changes worked very well.


What didn’t work as well as doing yet another Focusing exercise at the end of the first day, as an illustration of work intended to help clients access or heighten their emotions. So when we started running behind schedule at the end of the first day and I proposed to deal with this by dropping Clearing a Space, a couple of people questioned this. Fortunately, a break intervened, and thirty seconds’ reflection on my hasty decision led me to the conclusion that they were right. Therefore, I proposed going back to Clearing a Space and dropping the additional Focusing exercise. This was greeted with appreciation, and the final exercise of Day 1 came out really well. After all, Day 2 was going to be entirely devoted to Evocating Unfolding and Empty Chair Work, two key tasks for helping clients access their emotions.


Language localization also turned out to be an issue. Many EFT terms don’t have ready translations into Dutch. How do you say “emotion scheme” in Dutch? “Meaning Protest”? Or even, it turns out, “marker”? To date, the favoured solution turns out to be import the English directly into Dutch, on the grounds that Dutch has a limited wordstock that needs to be supplemented from other languages. This is very similar to the English-language practice of creating new technical jargon by importing Greek or Latin-based words, such as “empathy”, “schema” or even “ego”. This means that the Dutch jargon term is more removed from its metaphoric, bodily-based roots than if native Dutch words were used or even modified. I tried to propose “emotionale smedling” (from the verb “smeden”, meaning to form a plan, cognate with English “to smith”, i.e., forge) for “emotion scheme”, but so far have had no takers. No wonder; I don’t really understand the rules for Dutch-language word construction well enough to go around forging new terms!


Perhaps a more critical language issue is whether participants should do their skills practice in Dutch or in English. Actually, it’s clear that their work in the client and therapist roles needs to take place primarily in Dutch; however, this makes it impossible for me to follow their work well enough to be able to make suggestions when I float between small skills practice groups. As a result, I proposed that if skills practice groups wanted me to be able to intervene when I was in the room observing them, they could switch into English when I came into the room, and that if this was too difficult for the person in the client role, for the person in the therapist role to translate for me. This worked pretty well; I recommend it as a general procedure in non-English training situations.


Day 2 also went quite well, but as the intensity built, it became clear to me that one trainer is not really enough for 25 participants. The result was that I dropped a couple of balls in the last exercise, and the schedule went slightly awry. I missed working with Jeanne and other helpers, with some of them at least native speakers of the participants’ language. I’m strongly recommending having a Dutch-speaking helper for the next sessions I run in the Netherlands.


We have now scheduled EFT-1, part b, for March 5-6, 2010, and are exploring running a second EFT-1a in the south part of the Netherlands (probably Eindhoven) for January 2010. We also need to develop a curriculum for training Dutch-speaking trainers!

Thursday, October 01, 2009

September to October; Glasgow to Groningen

Entry for 1 October 2009:


Weds (30 Sept): Intense day discussing future of Counselling Unit as the University restructures. Lots to say about that, but maybe this is not the time or place to do it. Started orienting two therapists new to the Research Clinic; I could see that there was a lot to assimilate in this very complex research protocol, all the little bits that we’ve built up over the past 2 years. Worked with Anna, one of my PhD students on one of her ethics proposals; often it seems that the ethics proposal is the most labour-intensive part of my work with postgraduate research students.


Went home, helped Diane make a quick dinner, then our nightly dose of In Treatment: Week 7, episode 5, almost finished with season 1 of this amazing Israeli/American program about a psychodynamically-oriented therapist, four of his patients/clients, and his own therapy, which we follow for 8+ weeks, like a psychoanalytic soap-opera, which it is: Also intense, compelling. Last night was particularly amusing/poignant, as the therapist/protagonist, Paul, in for a couples session with his wife, Kate, gets dragged kicking and screaming by his therapist, Gina, into a a couples empathic listening exercise called Imago therapy. This turns out to be wildly successfull: Finally, after 8 weeks, he is able to listen to what his wife, Kate, has been trying to tell him… but is it too late? And what is the nature of the phone call he takes, somber-faced, as he and Kate leave the session? To find out, tune in next week! (But not from me; I don’t do spoilers…)


For once, I am reasonably well prepared for a trip: My handouts have been copied, thanks to a bit of help from Jeanette in our office, in exchange for some computer shopping advice. My slides may want a bit of fine tuning, but actually, it feels under control. Instead, I spend 3 hours plowing through another mountain of email, managing by my fingernails to keep my in-box down to 1100 (my new zero!). I only start packing for the next day's trip after 11pm, and manage to get to sleep sometime after 12.30am.


Thursday, 1 Oct: This is my youngest sister Louisa’s 50th birthday. (Yay, Louisa!) My family goes in for big celebrations on major milestone birthdays, and this one looks like a doozy... I’m sorry to have to miss it. Today is a travel day, one of those betwixt and between times that are like punctuation. I download 3 months of old email from my old account at the University of Toledo, finish packing my suitcase, etc. The taxi picks me up about quarter to 10, and it’s off to the Netherlands. The taxi driver is an unemployed rehabilitation therapist from Ghana; I end up telling him at the our postgrad diploma course in Counselling.


The day is lovely, mixed sun and cloud, light breeze, the flight uneventful. I sleep most of the way to Amsterdam, wait a long time for my suitcase, go out and buy my train ticket for Groningen and catch the 14.49 via Amersfort. How do the Dutch manage to keep their train lines so clean, trash-free, and well-manicured? Living in the UK, I always forget that it is possible to do so. At Amersfort, I have to change trains, but discover that it’s one of those split-train situations; at Zwolle, the front of the train will go on to Groningen, my destination, while the back of the train is destined for Leewarden. Anxiety: Am I on the right part of the train? (Once, trying to get to Brugge from Leuven, I ended up deep inside French-speaking Wallonia, so I take this seriously now.) As we pull into Zwolle, I am relieved to see that my part of the train has stopped in front of signs saying Groningen rather than Leewarden.


At Groningen, in the north of the Netherlands, instead of my usual 2-day EFT taster experience, I am going to try something new: Delivering the first half of EFT-1, with the second installment to follow, probably in March 2010. The Dutch PCE folks are eager to start up Dutch-language EFT training to compete with EFT – Couples (Sue Johnson and associates) and CBT, which dominates here as elsewhere. We are going to have to start a conversation, long over-due, about how to train the next generation of EFT trainers. I plan to work with Jeanne Watson and Les Greenberg to help our Dutch colleagues develop this training, which is planned as a top-up to a basic person-centred therapy training. I’m looking forward to it!


My hotel is the Hotel Corps de Garde, next to one of Groningen's canals and dating from the early 1600's, apparently built for the city guards to hang out. Retrofitted as a hotel, with eccentric metal circular staircase going partway up, then steep slanted stairs turning back on themselves to get me to the top. The woman from reception wants me to pay particular notice of the wooden beams, from 1628, prominently displayed outside (and it turns out, inside) my room. Renate has located 2 comic book ("strips" in Dutch) stores for me to track down volume 17 of Thorgal, a viking/heroic fantasy/science fiction graphic novel series that I have been working on for 5 years now as a way of practicing my Dutch. Both are closed (gesloten) by the time I get to them, but I run across a large bookstore that is still open, where, after some frustrated rumaging around, I manage to find the most recent number, volume 30, which I buy for want of a better alternative.


In my comic book quest, I've found the restaurant district in the old town, so I indulge one of my secret vices, doner kebab, before returning to my room to tackle the day's email and review my slides for tomorrow. As the evening progresses, the rain moves in, pounding against the skylights above and behind me. For a travel day, it's actually turned out to be fairly full.