Tom is a 27-year-old married but separated Caucasian male U.S. Army veteran who presented for treatment because he is tired all the time and wants help with his sleep. He feels sleepy during the day, often nodding during breaks at work, though it often takes him several hours to fall asleep at night. He stated that when he does sleep he has nightmares about his service in Iraq. He went overseas with the initial invasion force and participated in combat and house-to-house raids. He also provided aid to injured civilians on several occasions. He keeps to himself at work and in his daily life and as a result has minimal social support. He thinks others will judge him negatively because of his war experiences, and he also gets irritated by the questions civilians tend to ask (e.g., “Did you kill anyone?”). He stated that he would never use “drugs” but disclosed drinking heavily two or three nights per week in order to get thoughts about Iraq out of his head. He smokes marijuana occasionally, usually to stop unwanted thoughts or to calm himself when he is in social situations.