I thought I post this so you can save some time trying to optimize.
I just tested the settings for Very High on the Cheap from tweak town. Its perfect.
I run 1920 * 1200 no AA get about 22-25 frames per second (Very playable)
I went into the config directory copied all cvars (config files) then found the following values and changed them. I got a 8800GT btw. Run it in DX9 mode. The game just feels better and better day by day.

The amount of configuarablity in their graphics engine is just beyond awesome. Imagine 1-2 years from now when we got some newer card and you can just tweak the engine to look even more incredible.
Below is the changes (Courtesy of Tweak town)
'Very High' On The Cheap
There's another thing you can try if you find Very High mode is just a bit too strenuous for your system. You can try the "cheap" version of Very High, which basically only implements the more obvious visual enhancements of Very High. To do this, instead of editing your .cfg files as covered above, all you need to do is set your in-game settings all to High as normal, then add the following commands to your System.cfg file (or just test them in the console first): r_UsePOM=1, r_sunshafts=1, e_water_ocean_fft=1, q_Renderer=3 and r_colorgrading=1. This will make High look extremely similar to Very High in most respects, but with quite a bit less of a performance hit. In a pinch, if you still need extra FPS, try disabling one of the effects, though keep in mind that q_Renderer=3 is necessary for color grading to work. You can also turn off Edge AA (r_UseEdgeAA=0) to make things look crisper and boost performance further.