In this article, we critically overview existing studies on compensatory and dissociative mechanisms associated with problematic gaming, with a focus on escapism. Thus, we present a theoretical model integrating current research. In the first section, we link compensatory and dissociative processes related to gaming on a continuum that corresponds to the degree of connection/rupture between physical and virtual environments of the individual. In the second section, we discuss the strengths and limitations of existing conceptualizations and measures of escapism. We contend that escapism in gaming represents a key dimension of the compensation for difficulties in psychological needs satisfaction in the physical environment, differently from escape (avoidance) and from general immersion in video games. In the last section, we elaborate the Compensatory-Dissociative Online Gaming (C-DOG) model, which defines a set of interconnected psychological processes operationalizing the continuum between adaptive and pathological online gaming: relaxation, body-mind detachment, active escapism, escape, and dissociation. This model provides an unprecedented way to consider meaningful processes for the clinical evaluation and treatment of problematic gaming, as well as the association of problematic gaming with emerging social withdrawal conditions, such as hikikomori.