The most significant takeaway is his take on how, when Alice Cooper played, a bunch of people would leave. He saw that as a positive thing, because it suggested a level of discomfort with the music. Maybe the audience was unable to process it in the ways to which they were accustomed. Maybe they were able but found it distasteful. Whatever it might have been, it wasn't what they wanted, so they left.
This is a lot like some of the discussions over the last few years about Carcosa, Lamentations of The Flame Princess Grindhouse Edition (and the various LoTFP modules), etc. These are works which spawned a strong reaction, and a lot of negative reactions on top of it. Zak Smith has been someone who has worked tirelessly (probably because he also has been the target, repeatedly, of this sort of thing) to push back against people who were uncomfortable with this sort of thing, and, for whatever reason, thought they just had to push back against it.
But here's the thing. It's good to push your own boundaries occasionally. For example, I have a lot of music, and some of it is "challenging." It's weird, hard to listen to, loud, noisy, unpleasant, or whatever. Hell, some of it I don't even like very much. But I listen to it anyway. It reminds me that I'm not the only person in the world who likes music, and that what I like is a very personal decision. When something is not to my taste, it reflects where the boundaries lie between me and what is outside of me. Sometimes I keep checking these things out and discover that, hey, this actually is pretty interesting stuff (e.g., The Minute Men, some of the early, experimental punk/new wave stuff, and, yes, some of Frank Zappa's own work). Some of it I try and then decide that it's just not for me.
What I don't do is then go and decide that, just because I don't like it or don't approve of its moral or aesthetic frame, that it SUCKS and the people who like it are BAD AND WRONG!!!11eleventy!
To paraphrase, Zak S., liking pancakes is fine. Liking waffles is fine. Not eating breakfast at all is fine. But if I want some damned pancakes, then you don't have to eat them. Don't get in my face about how pancakes suck and I'm an asshole for liking them, and how I should only eat whatever it is that you eat because it's so morally and aesthetically superior. Fuck you! I like pancakes!
That's why I love the stuff that people like James Raggi produce, even if I don't play it myself. That's why I love it when people twist the standard gaming tropes in ways that are weird (e.g., gonzo approaches to regular fantasy and sci-fi). That's why I like outsider cultures in general. It's not the mainstream, it's weird, it makes a lot of people uncomfortable. I think that's a very, very good thing. Comfortableness is just a step away from stagnation.