Rory is taking a full course load, including a number of science classes. Both of her parents are physicians. Growing up, Rory never thought about being anything but a physician herself. She says she wants to be a physician, but she also feels a lot of pressure from her parents to be one. She is aware of how competitive it is to get into medical school, so she's very concerned about getting good grades in her classes right now. As midterms approach, Rory feels herself getting more and more stressed. She's having trouble sleeping, feels sick to her stomach, and has completely lost her appetite. She has gotten into several arguments with her spouse lately. To avoid further conflict, Rory tries to spend as much time away from home as possible, often studying at the library or a café until closing. She often doesn't get to bed until three or four in the morning, even though she has a Spanish class that meets every day at 9 a. m.