Boston Marathon a journey from trauma to recovery Boston Marathon survivor J.P. Norden at the Legs For Life Relay last week. The Boston Marathon course and the journey from trauma to recovery are running on parallel tracks this year. On Monday, runners will face challenges over a few hours that reflect the difficulties confronted over the last 12 months by spectators who suffered direct and indirect trauma after terrorists detonated two bombs at last year's finish line, killing three, maiming scores, and inflicting psychological harm on a city during its premier, communal event. Emotionally, the marathon has always been unidirectional. Spectators, especially those closest to the finish line, could always empathise with the pain and duress of the runners. Runners drew what energy they could from the crowd. It's fair to say they used the crowd. This year the relationship has changed. How serious, after all, are runners' foot blisters and leg cramps if measured against spectators who lost their feet and legs in last year's bombings? It's a new marathon covenant. Awe and empathy now must flow in both directions. Veteran marathoner Peg Rusconi has written a concise, mile-by-mile guide to the Boston Marathon. Dr Ellen McGrath, a psychologist and author, has written on the markers that trauma victims must reach on the road to recovery. Their works could serve as companion pieces for the 2014 Boston Marathon. Marathon runners often report spending a restless or even sleepless night before the race. They're a bundle of nerves at the starting line, kept physically in check only by the mass of other runners pressing in on them. Barely under way, runners quickly confront a drop of almost 40 metres, the steepest downhill along the course. Precious little thinking takes place at this point, according to Rusconi. Runners are in a haze. McGrath describes the first stage of the traumatic experience as "circuit breaking." Brain activity reduces as the victim's system shuts down to compensate for all of the danger, pain, and craziness around them. Many people noticed that some of the most seriously injured spectators at last year's marathon displayed an oddly serene countenance. They had entered what McGrath calls the "trauma zone." The pack begins to thin out over the next 13 kilometres. The terrain is mostly forgiving, with gentle dips and gradual ascents with only a few minor perils to negotiate, such as train tracks. Still, the mainly flat surface gives some runners a false sense of security. Rusconi cautions runners about getting too far ahead of their pace during this stage of the race. They can damage themselves. McGrath identifies the second stage of trauma recovery as "the return of feelings." Some victims want to return to the site of the traumatic event during this period. And nearly all victims benefit from talking in minute detail about their experiences. For some people, the emotions trickle out. For others, they ebb and flow. But for those who repress their feelings, huge waves of emotion can arrive without warning, overwhelming the victim. The crowd noise picks up during kilometres 19 through 24. The terrain and the people are friendly, with lots of reminders that the runners are halfway home. Runners also need to remind themselves that they are closing in on the most difficult part of the race. Less-experienced marathoners can crack at 25-27 kilometres, which includes an 800-metre long hill and a barren overpass where runners are exposed to crosswinds. McGrath describes the third stage in trauma recovery as "constructive action," when survivors take back control and start to overcome their sense of powerlessness. Victims want to meet their rescuers and connect with other trauma sufferers and their families. Often they go back to work. Such actions, writes McGrath, become "an engine that propels you forward." The next few kilometres are largely downhill, but nothing comes easily after 37 kilometres of pavement pounding. A small grade at 40 kilometres can appear insurmountable. But then, at the crest, Fenway Park comes into view. Huge, roaring crowds await in Kenmore Square. Signs indicate just 1.6 kilometres to go. Soon comes the vaunted right turn onto Hereford Street, which Rusconi depicts as a "scream tunnel" in the joyful sense of the term. Finally the turn left at Boylston Street and the blue and yellow finish line. The last piece in trauma recovery is what McGrath calls "reintegration." People are smarter, stronger, and more insightful for the experience. A lash of new bone has formed around "the broken bones of the soul." This year's marathon stands for regeneration, a concept that might be difficult to upload in photos and videos along the race route. But the message will be communicated over every step of the race. Runners and spectators are able to move forward together because the bombings and their aftermath - in the deepest sense - fused them into a state of wholeness. Lawrence Harmon is a columnist for the Boston Globe