Abstract: This article explores the problem of communication between a psychiatrist and a patient with mental disorder. The authors review the specificity of psychiatry as a science. Special attention is given to the methods of making a diagnosis on ICD-10 and the problem of therapy of an “interpretive” nature. The authors meticulously elucidate the problem of communication between a psychiatrist and a patient. Attention is paid to verbal communication and its hermeneutic character. The article gives a detailed examination of the position of a psychiatrist with regards to the patient, as well as distorted agency of a patient and methods of its correction. Attention is also given to the modern methods of communication between a psychiatrist and a patient (Internet). Specificity of psychiatric care use researched using the historical method and method of philosophy of science. Among the main conclusions of the conducted research is the thesis on duality of psychiatry as a science and the possibility of the subject-to-subject communication between doctor and the patient on the basis of phenomenological method in psychiatry. Special contribution of the authors consists in the analysis of the distorted agency of a patient and neurotypical agency of a psychiatrist. It is established that the psychiatrist can find a resonance with the patients and achieve communication of the level of empathy using the hermeneutic approach.