This paper investigates case conceptualization and treatment of post-traumatic stress disorder (PTSD) with moral injury in military veterans via the fictional character Jacob Nicks from the American drama film An Act of War (Shah & Kennedy, 2015). Because Jacob suffers from psychosis and dies by suicide in the film, I take several liberties in my case conceptualization. I preface our therapeutic work with the assumption that Jacob’s brother has intervened, he has received in-patient psychiatric treatment, and he is referred for trauma counselling by his psychiatrist after stabilization. I use the DSM-5 diagnostic criteria for PTSD in my case conceptualization and define moral injury as representing “the potential negative outcomes following transgression of deeply held moral values and beliefs” (Farnsworth, Drescher, Nieuwsma, Walser, & Currier, 2014, p. 249). I conclude with a strategy for self-care and, in Appendix A, reflect on the experience of case consultation with a colleague.