Sentence:  one cannot assume , of course , that all these accumulated meanings were inherent in the stereotype at the beginning of the therapy , or at any one time later on when the stereotype was uttered ; probably it is correct to think of it as a matter of a well grooved , stereotyped mode of expression - and no , or but a few , other communicational grooves , as yet - being there , available for the <WSD>patient</WSD> 's use , as newly emerging emotions and ideas well up in him over the course of months . 
Meaning of the word marked with <WSD> tags:  a person who requires medical care