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OCD treatment in Houston & across Texas
OCD is frequently hidden for a decade or more, usually because the intrusive thoughts feel too shameful to say out loud. They are a symptom, and they are treatable.
What OCD actually is
Obsessions are intrusive, unwanted thoughts, images or urges that cause significant distress. Compulsions are the behaviours or mental acts performed to reduce that distress. The relief is real and it is temporary, which is precisely what makes the cycle self-reinforcing.
The popular picture — tidiness, hand-washing, symmetry — describes a fraction of presentations. Much OCD is entirely internal: repeated mental checking, reassurance-seeking, rumination, mentally reviewing conversations, or silent counting.
The themes people do not mention
Intrusive thoughts are frequently violent, sexual, religious or blasphemous in content, and they are almost always the opposite of what the person values. That is exactly why they cause such distress, and exactly why patients wait years before telling anyone.
These thoughts are a recognised symptom of a recognised illness. They are not intent, they are not character, and they do not shock a psychiatrist who treats OCD. Saying them out loud is often the first point at which treatment becomes possible.
When it is time to see a psychiatrist
- Obsessions or compulsions consume significant time each day.
- You are avoiding situations that trigger them.
- You are seeking reassurance repeatedly from family, from doctors or online.
- Relationships or work are being affected.
- You have never told anyone the content of the thoughts.
How Dr. Torrijos evaluates OCD
The evaluation identifies the specific obsessions and compulsions, how much time they take, what avoidance has built up around them, and what else is present — OCD frequently co-occurs with depression, anxiety disorders and tic disorders. Conditions that can look similar, including generalised anxiety and some presentations of ADHD or autism, are considered explicitly.
Treatment options
OCD responds to specific treatment. Exposure and response prevention, a form of cognitive behavioural therapy, has the strongest evidence, and where it is indicated you will be told so and helped to find a therapist trained in it — ordinary talk therapy is often not effective for OCD and reassurance-based therapy can make it worse.
Medication has a well-established role, often at higher doses and over longer trials than in depression, which is a common reason treatment is judged to have failed when it was simply not given enough. Combining medication with ERP outperforms either alone for most patients.
What treatment looks like at Tentie
Unhurried evaluation with no reaction to the content of your thoughts, a treatment plan built with you, and coordination with an ERP therapist where that is the right lead. Follow-ups track time occupied and functional impact, not just distress.
Start with an evaluation
| Patients | Adults 18+ |
| Evaluation | Up to 90 min |
| Fee | [$XXX] |
| Format | In person or video |
| Languages | English, Spanish |
Reviewed by José M. Torrijos, MDBoard-certified adult psychiatrist, licensed in Texas. Last reviewed August 2026.
Related
Frequently asked
Are my intrusive thoughts dangerous?
Intrusive thoughts in OCD are ego-dystonic — they conflict with your values, which is why they are so distressing. They are a symptom of the illness. This is standard clinical territory and not something that will be met with alarm.
Why do I need a specific kind of therapy?
Exposure and response prevention has by far the strongest evidence for OCD. General supportive therapy, and particularly therapy that provides reassurance, can reinforce the cycle rather than interrupt it.
How long does medication take to work in OCD?
Longer than in depression — often eight to twelve weeks at an adequate dose, and adequate doses in OCD are frequently higher. Trials abandoned at four weeks are a common reason patients believe medication does not work for them.
Can OCD be treated by telehealth?
Yes, both evaluation and medication management. ERP therapy is also delivered effectively by video by therapists trained in it.
I’ve had this since childhood. Is it too late?
No. Long-standing OCD responds to proper treatment. Many patients seek help decades after onset and improve substantially.