A combination of a support group, a self-help program, and lexapro is working well for me. I have found that the lexapro doesn't completely control the thoughts, but it makes it possible for me to deal with the anxiety inherent in using the support tools: exposure, imagery, and ritual prevention. In a few months I have been able to decrease my handwashing, checking, and counting.

I recomment the OCD workbook by Hymen and Pedrick, Stop Obsessing by Foa, and Brainlock by Schwartz. My doctor has been supportive of my decreasing the medication and eventually stopping it. (I have negative reactions to the lexapro and all of the other SSRI's I have tried.) It is hard work and the anxiety in not performing the rituals seems unbearable at times, but I find that I eventually habituate to it. Good luck!

-apislily