Presents a case study of a 66-year old single white male who presented for treatment of his obsessive-compulsive disorder (OCD), which had become progressively worse since his retirement four years prior. He described a secondary social isolation, which did not appear to be his major concern. He had been in unsuccessful medication treatment previously. The comorbid presence of Axis I and Axis II disorders can create difficulty in the treatment of Axis I disorders and should be watched for, especially in cases considered treatment resistant. Although few formal guidelines exist for treatment in this combination, there might be one or two informal guidelines. First, treat the Axis I disorder adequately as it may respond in whole or in part. Second, examine ways that the personality disorder might be interfering with treatment so that proper interventions can be taken. Finally do not get discouraged if the patient has prominent personality traits. On the one hand the traits are changeable, and on the other hand many people with prominent personality traits function reasonably well in society. Even if the personality traits do not change, these types of patients might find ways to better fit in and function with the personality traits they have. (PsycINFO Database Record (c) 2012 APA, all rights reserved)