Hi JK1967,
I have respect for you, dealing with such hard OCD. I have it in thoughts mainly, and in alignment obsessions. I think that it is tied up with the panic, anxiety, depression and all that stuff that we tend to have as well.
It is my belief, after 45 years of various horrible symptoms, that for me the bottom line is FEAR. In three hours time I am getting on a flight to Spain. I was 40 before I could fly on a plane, and my father (also a sufferer) could never fly or even use public transport. He once paid to go 120 miles in a taxi because he was frightened of going on the train.
I know now that all the rituals in the world won't stop a panic attack and if I get one I will survive it. This single understanding has enabled me to travel, both with my family and also alone. I have even been travelling abroad alone with horrible IBS, and still enjoyed the victory.
I'm not saying that we can always defeat this stuff with willpower, because we surely can't, but I am saying that I have managed to reduce some of my barriers through facing the spider at the bottom of my particular barrel. It doesn't bring relief, but you do get to see some different scenery along the way.
Good luck, and I hope it gets easier for you.