Many Boston Marathon bombing victims weren't physically hurt in the attack but have lingering fears and anxieties, and some of them feel that their wounds are overlooked amid the victims with catastrophic bodily injuries. Rebecca Rosenblum is co-coordinator of the Boston Area Trauma Recovery Network, which is offering free treatment to survivors of the attack. When she spoke with WBUR's All Things Considered host Sacha Pfeiffer, she said she's concerned that many people may need therapy for what they experienced, but aren't getting it.

Rebecca Rosenblum: You can go through a very difficult experience like this and tell yourself that you're doing okay and you're getting through your routines, but in fact there have been changes that have happened. Maybe you're not sleeping well, maybe you're having nightmares, maybe you're starting to lose weight, maybe you've increased how much you drink or use coffee or smoke. And what you find is that people have a way of telling themselves that they need to soldier on and keep going, and so they don't really think that they need to reach out for help until they're inundated with something like an anniversary and realize, 'Hmm. Maybe I'm not quite doing as well as I thought."

Sacha Pfeiffer: Are you finding that the people who are reaching out for help are people who were at the marathon finish line, or at the course, or does it extend even beyond that?

It really does extend beyond that. Of course we are getting people who have been physically injured, or people who weren't physically injured but were there and saw and heard all kinds of things that you don't see and hear in the normal course of life. But we've also gotten referrals of people who come in, who maybe they grew up in a high-conflict area somewhere outside the United States and thought that they were safe because they thought things like that don't happen here. And then something like that happened here, and then all of those old traumas are re-triggered and they come in for help.

I've also heard mentions in recent weeks that the people who lived in the lockdown communities have their own set of issues to deal with. Are you finding that, as well?

Absolutely. Very much so. I mean, a lot of the people who were locked down in Watertown, who were exposed to seeing lots of military vehicles, SWAT teams — all kinds of things that maybe you see on television but you don't see in your backyard, are difficult for people to go through. People who've had homes that were caught in the crossfire or people in the MIT community who knew or had talked to the officer who was shot, or just kind of go about those locations every day and then suddenly something like this happens.

And the group that you work with, the Boston Area Trauma Recovery Network, has a very specific type of treatment you use in these cases?

Yes, we do. We offer pro bono EMDR therapy. EMDR stands for eye movement desensitization and reprocessing, and it has a history of working with traumatic events, with PTSD symptoms. Yes, we do. We offer pro bono EMDR therapy. EMDR stands for eye movement desensitization and reprocessing. It's a combination of recalling an event that you've been through with what we call bilateral stimulation, which can be eye movements or tones or tapping, which activates each side of the brain, different hemispheres, in rapid succession. And that whole process really shifts the neurology so that people get unstuck, so that people can calm down intrusive images and get back to their level of functioning before this whole thing happened.

What do you think are the consequences of possibly holding things inside or not talking about this?

We often see full-blown PTSD develop. It can develop as long as three years after having been exposed to an event like this. Sometimes what happens is from that people develop profound depression or anxiety symptoms. It affects their relationships, it affects their ability to do their jobs properly, and really kind of shuts down their ability to access enjoyment in the world.

Is the idea here also that if you think you're doing OK because you're able to talk about it with a spouse or with a friend, sometimes that's not enough?

Absolutely. So maybe a good analogy is if you think about back pain, when you're 25 and you go out and shovel, you might feel a little twinge [but] because you're 25 you get back to it and you're just fine.

You bounce back.

Right. And so you don't really think that there's been any ongoing damage that's happened in the muscles and the nerves and all the ligaments holding your spine together. And then, you know, a little while later, like when you're 45, you bend down to pick up a basket of laundry and all of a sudden you can't walk right. And so oftentimes people can go through something and feel like they're OK, and then suddenly you're not doing OK.

A lot of people are trying to decide what they want to do on marathon day. Should they be there, are they obligated to, do they want to be far away. How do you advise people who are trying to figure that out?

I think it's really important to check in with yourself and see what leaves you feeling safe and comfortable. If you're the kind of person who's really stubborn and is like, "Okay, I'm going to go out there and be there because I'm going to reclaim the experience for myself," then that's what you need to do. If you're feeling like it's going to be really difficult to be in crowds, it's going to be really difficult to see all the kinds of things that cue your memories of what happened last year, then it might be better to take a step back.

Boston Marathon victims interested in receiving free short-term trauma treatment from the Boston Area Trauma Recovery Network can call or text 774-292-0877 or email BostonAreaTRN@emdrhap.org. Therapy is available at treatment centers in downtown Boston, Cambridge/Somerville and Hopkinton between April 14-27 — and possibly longer, depending on demand. For the next year, the network will also be accepting referrals at therapists' offices throughout eastern Massachusetts.