I’m a hardcore geek and have been since the earliest of my days. It’s effected my literature choices, music choices, hobby choices, etc. But aside from my geekery I’m also pretty well adapted socially. I work with non-geeks in a non-geek profession doing non-geek things the majority of my time. But I love it when I get to gaming sessions and the joke of “can you get me a Mt. Dew… it’s in the fridge” results in gales of laughter.

It’s a chance for me to let my geek flag fly.

I think your last point, that DMing can be a brief escape from reality, is an important one. I also think it applies to players as much, if not more, than it does to DMs.

I believe that Aristotle nailed it on the head when he talked about catharsis. Experiencing something vicariously, whether it is through a dramatic situation like a movie, or whether it is through a game, provides a certain benefit to the psyche that human beings need to have. By role-playing, we exorcise many of our inner demons, and we hone our own personalities.

Some of the more modern psychological approaches suggest that the opposite is true: playing violent video games makes you violent, playing a fantasy game like D&D separates you from reality, etc.

This, I think, does a disservice to humanity. The paradox that playing fantasy RPGs can actually make a person more in tune with reality is something people don’t want to hear.

Now, can these games, for the person who is mentally ill, create problems? Sure. But, so can pancakes. Are there times when a person is so immersed in fantasy that they lose touch with reality? Sure. But these are the exceptions that make the rule.