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 <WSD>uttered</WSD> ; 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 patient '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:  articulate; either verbally or with a cry, shout, or noise