“Do they understand how damaging it is?”
That’s a question I’ve tried to work out. Over time I’ve asked, didn’t the abusing Pdoc in my case have an Ethics course in Med School? He was asked this during deposition and responded that no, he’d never taken an ethics course. Probably a lie. At the very least he had to have known about or taken the Hypocratic Oath.

There are many possible reasons questionable therapists disregard the damage this does to clients/patients. They certainly disregard how damaging it can be for themselves and their own families if they are discovered. Some therapists are sociopaths, and think only about themselves. I know of a few instances where the therapist not only exploited the patient sexually, but frauded them out of their money, as well. Some questionable therapists disregard the harm to patients because it’s a power trip for them. There are also questionable therapists who really believe they are ‘in love’ with the client/patient. I’ve read the term, ‘love-sick therapist.’ Some questionable therapists are ‘risk-takers.’ Then there are therapists who have impaired judgment due to substance abuse or mental illness. I think there are a multitude of reasons- sometimes the reasons are overlapping.