I’ve been wondering a lot about therapy: how many people should be doing it? Should I be doing it? With what goals? For how long? What type?

I do not have good answers for these. But I came up with a nice dubious ontology that nevertheless helps me think about this: there are strategy therapists and tactics therapists.

If life were a baseball game, the strategy therapists would be teaching you when to keep a pitcher in or when to take him out, when to shift your fielders, how to run on anything when there’s two outs but be more cautious on fly balls with 0 or 1 outs, how the infield fly rule works, and so on. The tactics therapists would be teaching you how to hit the ball.

Strategy therapists include most talk therapists. They’re good for big-picture framing problems, like “I’m not lazy, I have ADHD” or “am I gay but too afraid to even realize it” or “I’m struggling with alcohol because my dad did too and it trained these patterns in me”. These are a lot of the “therapy success stories” you hear about, because they’re easy to tell. If you make big progress on your problem, and you can explain that progress in words, it was probably a strategy problem.

Tactics therapists are more varied. Some things that I’d consider tactics therapy:

• exposure therapy/ERP for OCD (slowly get you closer to the thing you fear)
• IFS, or anything that involves some kind of improv (sorry if this is misunderstanding IFS, I just mean like, talking to different parts of yourself as if they’re there, not thinking through your problem)
• bodywork/massage/cranio-sacral/etc; progress in these is usually less linear but sometimes your body just feels better and that lets you solve the problem
  • certainly anything where you e.g. release a muscle knot and the tension around your problem dissolves is tactics
• EMDR, probably?
• Begrudgingly, CBT - but I think tactics that go through thoughts are usually less effective than ones that go through feelings or body sensations
• psychedelics can be both, but I’d guess they’re more often tactics, based on how hard it can be to put their lessons into words.

Tactics solutions sometimes can be put into words, like: “when someone criticizes something I did, I take a deep breath and remind myself that it’s not a criticism of me” or “I stopped tensing my shoulders so much.” Sometimes the result can be put into words, but not much of a reason: “I just feel more at ease” or “I’m not so afraid of spiders - I always knew they’re mostly safe, but now I really know it.”

Both are good and have their places, of course, but I’m finding myself gravitating more towards tactics therapies. They seem generally higher value; sometimes they bubble up into a fix for a problem, or sometimes they dissolve the problem because it’s no longer relevant. And at least, when they’re good, they provide some targeted support. But this may be because I already overthink everything, and I can tell you a pretty good and coherent narrative of my life.¹ As a result, I’m a little bummed that strategy-therapy seems to be the default. Well.