The Medium Trophy & Achievement Guide

Welcome to the Trophy & Achievement guide for The Medium! This is a very easy Trophy/Achievement list to complete. A majority of these Trophies/Achievements are all tied to certain points of the story that can’t be missed. There are no difficulty related Trophies/Achievements and everything can be done in one play through.

As easy as this list is, there are a few missable Trophies/Achievements that you need to be aware of. This isn’t an open world game, so there is no free roam after you beat it. If you miss anything, you’ll have to either reload a previous save file or start over from the beginning. There are a lot of collectibles to find, but this is a pretty linear game, so they’re not that difficult to track down.

completionist medium platinum trophy achievement Completionist

Collect every other Trophy.

the medium trophy & achievement guide

insightful trophy achievement Insightful

Use Insight for at least 15 minutes.


Insight is a mechanic used when playing The Medium. Hold L1/LB to use it. This Achievement is accumulative. It’ll track and add to your time each time you use it throughout the game. You’ll likely get this without trying, but you can always just sit there holding L1/LB until it pops if you’d like. Just be aware of this and be sure to use it. This could potentially be missed.

left behind trophy achievement Left Behind

Find an Echo.

See “Calling Out to Me” for more details.

calling out to me medium trophy achievement Calling Out to Me

Find all Echoes in a single playthrough.


There are 32 Echos to find in The Medium. These are random items found throughout the game that have Echos attached to them. Hold L1/LB while inspecting the item with the right stick to reveal a glowing section of it. Hold it there and a memory will play. You’ll hear faint Echos when you’re near one of these.

See “All That’s Left Unsaid” for a full text guide on all needed collectibles.

i know the pieces fit medium trophy achievement I Know the Pieces Fit

Reconstruct a Memory Shard.

See the “Puzzling Out the Past” for more details.

puzzling out the past medium trophy achievement Puzzling Out the Past

Reconstruct all Memory Shards in a single playthrough.


There are 10 Memory Shards. Memory Shards are a collectible type that require you to recreate memories in the other world. You’ll know when one is near when you see white feather looking objects floating. Interact with them and then turn the left stick to form them back into shape. Once they’re back in shape, hold it in place for just a second to complete it and a short memory will play.

See “All That’s Left Unsaid” for a full text guide on all needed collectibles.

guiding light medium trophy achievment Guiding Light

Find a page from a mentor’s diary.

See “Devouring Darkness” for more details.

devouring darkness trophy achievement medium Devouring Darkness

Find all pages from Richard’s diary in a single playthrough.


These are labeled as “Mentor’s Diaries” in the game. There are seven of them to be collected. These are notes that can be picked up.

See “All That’s Left Unsaid” for a full text guide on all needed collectibles.

a dangerous method medium trophy achievement A Dangerous Method

Find a note from a troubled man.

See “An Unknown Outcome” for more details.

an unknown outcome medium trophy achievement An Unknown Outcome

Find all of Thomas’ notes in a single playthrough.


There are 20 of these to be found. They are labeled as “Troubled Man’s Notes” in the game. Like the diary pages, these are notes that can be picked up.

See “All That’s Left Unsaid” for a full text guide on all needed collectibles.

from niwa with love medium trophy achievement From Niwa with Love

Find a postcard from the groundskeeper.

See “All That’s Left Unsaid” for more details.

all thats left unsaid medium trophy achievement All That’s Left Unsaid

Find all of Frank’s postcards in a single playthrough.


There are 11 postcards to be found in The Medium. Below is a written guide of where to find all of the collectibles that are required for Trophies/Achievements. The Erie Drawings, Other and Photos are not needed. Following the guide below will earn you every collectible related Achievement in The Medium.

  • Postcard 1 Niwa Says Hello – The first collectible is found inside the guard house at the gate of the Niwa building. Pick it up before climbing over the wall.
  • Postcard 2 Honest Work – After you complete the first Spirit Charge puzzle, you’ll find yourself in a large open parking lot outside of the Niwa building. Go to the left side to find a car. The postcard is inside this car with the screwdriver.
  • Echo 1 – This is located on the payphone in the center of the Niwa parking lot near the entrance.
  • Echo 2 – As soon as you get inside of Niwa, look to your left. The echo will be on a shoe on the ground.
  • Postcard 3 Promotion – In the lobby, go past the destroyed staircase and elevators. This postcard is found on an ashtray on the right side behind the elevators.
  • Echo 3 – This is upstairs on the 2nd floor on a phone. Find the key and then enter the room on the right. Go through the bathroom and into another room. The phone is on a shelf near a window. Make sure to pick this up before dropping into the hole in the floor.
  • Memory Shard 1 – This is found by interacting with a book on the left side of the room you drop into via the hole in the floor.
  • Mentor Diary 1 An Apology – Go into the bathroom of the same room with the book Memory Shard. This page is found in the sink.
  • Echo 4 – This is found on a bottle of pills in the same sink as the previous Mentor Diary. Right next to it.
  • Echo 5 – After cutting down the skin wall, enter the next room via the balcony and go into the bathroom. This can be found by interacting with the mirror above the sink.
  • Memory Shard 2 – Exit the bathroom and go into the room on the left through the hole in the wall. Interact with the bowl on top of the boxes just past the sunflower.
  • Troubled Man’s Note 1 A Peaceful Place – After cutting down another skin wall followed by the second hallway full of moths, enter the doorway on your left and come toward the camera a bit to reveal this note in a crate.
  • Troubled Man’s Note 2 To Do List – This is found on Thomas’ desk after a scene with Sadness.
  • Troubled Man’s Note 3 Getting Stronger – This is found inside of Thomas’ secret room behind the bookcase. This is on the floor on the pentagram like drawing.
  • Troubled Man’s Note 4 Fever Dreams – Head toward the Dayroom, but the actual room will be locked for now. Go right toward a glass door and you’ll find this note behind a pillar.
  • Echo 6 – In the room with the pool, follow it around to the back and you should see some barricades up in a corner. This Echo is on one of the barricades.
  • Echo 7 – From Echo 6, drop into the pool and interact with another barricade. This one is propped up against the back wall of the pool.
  • Echo 8 – Climb out of the pool and exit the room through the door to the right of the barricade where Echo 6 is. Crawl through the hole in the wall in the next room and then interact with a pair of shorts on the ground.
  • Postcard 4 Someday – Turn around from the last Echo. Go right and then to the back of the room to grab this Postcard out of a box.
  • Troubled Man’s Note 5 Good Old Frank – Exit the room from the previous Postcard and follow the hallway up stairs. When you exit into another hallway, walk toward the camera a bit and this will be found on the ground on the right in front of a closed door.
  • Echo 9 – A little bit further in the story, Sadness will lead you to some toys by using your Insight ability. These toys will be Echo objects.
  • Echo 10 – Continue following Sadness’ Insight trail to a toy dog in the pool.
  • Echo 11 – Continue following the Insight trail. Pop back up out of the pool to interact with a toy bear.
  • Echo 12 – Continue following the Insight trail out of the pool room and into the room with the hole in wall. Move the cart on the left out of the way to reveal the toy tank.
  • Echo 13 – This can be found after the second encounter with the creature. Run all the way down toward the camera and hide behind a shelf. Sit there and wait for the creature to come down. He’ll break the door down and walk out. When he leaves, you’re free to explore again. Now, walk out the door that the creature went through. Straight across the hall is another door with a sign that says “Examination Room.” Go in here and head to the left and interact with the phone on the wall.
  • Postcard 5 A Scenic View – To the right of the last Echo, a key can be found on the ground next to a cabinet. Pick up the key and use it on the door in this room. Walk through this door and turn left. Follow the walkway down to a corner on the right and pick this postcard up off of a trash can.

The next section of the game will require you to find two masks for two souls stuck next to each other. You can do either side in whatever order you want. For this guide, I started by going after the soul on the right first.

  • Echo 14 – After being chased by the creature again, you’ll squeeze between an overturned table and bookshelf. Just after this will be a room on the left. Enter it and this Echo is found on the back of an autographed ballerina picture on a table at the end of the bed.
  • Echoes 15, 16, 17, 18 – Pick up the Torn Notebook Page in the next room after going through the mirrors at the foot of the bed. Now interact with the notebook on the table to the right of the mirror. Place the torn page here. Each one of the numbers on this page are an Echo. Interact with each one.

Follow the story and you’ll pick up the first mask for this section. Now we’ll be headed for the soul on the left and the rest of the game.

  • Echo 19 – Follow the story until you exit out of a mirror from the other world back into a conference room in the real world. Head down toward the camera and interact with a phone on a shelf on the left of the room.
  • Echo 20 – Eventually you’ll end up in a room that has tables and numbered chairs in a U shape. This Echo can be found in this room on an ash tray on a desk near the front. *Note* After finding the name you need in this room, the creature will come after you when you exit this room. You can run back in and hide behind the desks and wait him out. He’ll come in and then leave when he can’t find you.
  • Echo 21 – After freeing Nicholas and Tori, you’ll end up going through a mirror back to the real world and you’ll be in a bedroom with a hole in the wall right next to the mirror that you can walk through. Go through the hole and interact with the wheel chair in this next room.
  • Troubled Man’s Note 6 Dust and Death – Follow the story and pick up the bolt cutters needed to progress through the Dayroom. Before going into the Dayroom, you need to head back out to the Niwa lobby. Follow the lobby hallway all the way down past the elevators to the locked gate. Cut the chain on this gate with the bolt cutters and enter. This note is found on a desk at the very end of this hallway.
  • Mentor Diary 2 Throwing Away Greatness – Enter the Dayroom and follow the hallway. A cutscene will play. When you get control back of Marianne, turn left and pick up the note on a stack of boxes.
  • Echo 22 – This is right next to the previous Mentor Diary page. It is a drawing of two horses.
  • Mentor Diary 3 A Very Special Boy – From the previous two collectibles, go right and pick this page up on a couch against a wall with windows.
  • Memory Shard 3 – Turn around from the previous collectible and head to the center of the room and interact with an IV bag.
  • Mentor Diary 4 A Well of Inspiration – Head over to the right side of the room and this page can be found on a chair against a green wall with flowers painted on it.
  • Mentor Diary 5 A Method to Madness – Go back across the room to the left and enter the open doorway next to the couch that had A Well of Inspiration on it. This will be on a desk immediately to your right when you enter.
  • Memory Shard 4 – After the globe puzzle, walk out the backdoor onto the balcony and to the next room. Interact with the object on the desk to the right of the piano.
  • Echo 23 – Pick up the key in the piano room and exit. You’ll have to cut down another skin wall. You’re back in the main Dayroom. Head over to the left side where the locked door is and use the key on this door. Enter the room and interact with the pen case on the coffee table.
  • Memory Shard 5 – Walk over to the L shaped desk in the top corner and interact with the pair of glasses on the desk.
  • Mentor Diary 6 Growing Apart – This just to the left of the glasses on the same desk.
  • Mentor Diary 7 A New Home – After the piano puzzle, go down the hallway with the moths and into a somewhat large open room with big windows on the side. Head straight to the back of the room from the stairs to a desk with a red chair in front of it. This is on the desk.
  • Memory Shard 6 – From the previous Diary page, go left and interact with the painting.
  • Memory Shard 7 – If you use your Insight ability, you’ll notice a trail. This trail will lead you to the next Shard. Its a doll near the base of the stairs.
  • Memory Shard 8 – Follow the Insight trail to the left side of the room to a red bow on a table with a white tablecloth.

There are no collectibles during this next gameplay section. So enjoy your break from the collectible grind. The collectibles will pick back up when you regain control of Marianne.

  • Postcard 6 Won’t Stop – When you regain control of Marianne and are outside, go down the left path and then take the first left to find this postcard on a bench.
  • Echo 24 – From the previous collectible, go down just a bit to a payphone that you can interact with.
  • Postcard 7 Poor Thing – Head back to the four way intersection like sidewalks and take the exit at the top of it. Follow the path until you come to an area with viewing binoculars. This Postcard is on a bench to the right of the binoculars.
  • Postcard 8 Harder and Harder – Follow the path from this area to the right until you come to a fork in the road. Take the left path and follow it until you come across a bench on the left side. The Postcard is on this bench.
  • Postcard 9 Whispers in the Dark – Continue following the story path until you meet a dog. The dog will want you to follow it. There will be another fork and the dog will be barking at you from the left path. Before following it, take the right path. Just before you come to the river, there will be a little area with a bench on the left. The Postcard is on the bench.
  • Postcard 10 A New Companion – Get back to the dog and follow it. It’ll lead you to a campsite with a tent. This is not to be confused with a small shack that you’ll pass. Side note, interact with the shack to find some dog food that you can use to feed the dog. Come on, feed the dog. Anyway, continue on and a cutscene will play involving the tent. When it’s over, do not interact with the tent yet. Instead, turn left to find this Postcard on a bench.
  • Postcard 11 Regrets – Now you can interact with the tent. This Postcard is found inside the tent on the ground next to a boot. There is also a Photo in here you can take, but it is not needed for any Achievement.
  • Echo 25 – After a cutscene with Sadness, you’ll be walking toward a house. Keep going until the house is on your right and the camera changes. Straight across from the open door of the house is a pack of cigarettes that can be found on a rock.
  • Echo 26 – Just to the right of the previous Echo is a tire propped up against some rocks. Interact with it.
  • Echo 27 – Go into the house on the right and you’ll find a wooden horse on a work bench. Interact with it.
  • Troubled Man’s Note 7 Hell’s Angel – This is pinned up just above the previous wooden horse.
  • Echo 28 – From the previous two collectibles, head through the door and into the garage section of this house. Go toward the screen to the bottom left corner of the screen to find a tape recorder on the ground.
  • Troubled Man’s Note 8 Something Broken – This note is found on a work desk just to the right of the previous Echo. It’ll be on the bottom shelf.
  • Echo 29 – This Echo is actually the suitcase just above the previous note.
  • Memory Shard 9 – After solving the garage puzzle, head out and toward The Red House (burned down house) and then go to the left. Inspect a gas can outside on the left side of the house.
  • Memory Shard 10 – From the previous Shard, head back around to the front of the house and interact with a rusted object on a white crate.

There are no collectibles during this next gameplay section. The collectibles will pick back up when you regain control of Marianne.

  • Troubled Man’s Note 9 Demons – Enter the house and go straight back on the right side to a doorway blocked by fallen furniture on the other side. The note is on the furniture.
  • Echo 30 – Solve the dollhouse puzzle and gain access to the basement of the house through the now broken mirror. Go straight back to the left to find this Echo on a teddy bear on top of some boxes next to a box of books.
  • Echo 31 – This is on a syringe on a shelf under a window to the right of the previous teddy bear. This Echo is kind of a pain to get to register. You have to get the Echo facing toward the left.
  • Troubled Man’s Note 10 A Different Kind of Sickness – This note is just to the right of the previous syringe on the corner of a dresser.
  • Echo 32 – Turn around head toward the opposite side of the basement. Just before the exit doorway, there is a shoe on a broken chair that you can interact with.
  • Troubled Man’s Note 11 The Missing Piece – From the previous shoe, keep heading in the same direction. This note can be found on a desk on the left side of the screen opposite of an open doorway.
  • Troubled Man’s Note 12 Found a Way – Head into the open doorway opposite of the previous note to find this one on a box on the ground. The code for the next door 1966.
  • Troubled Man’s Note 13 Separation – After leaving the basement, you’ll be chased once again by the creature. This note is found in the room where the chase will end on a pile of wooden boxes.
  • Troubled Man’s Note 14 A Relic of the Past – This is found in the pump control room after turning off the electrified floor. This note is on the far left side of the control console.
  • Troubled Man’s Note 15 A Thin Line – After yet another chase scene involving the creature, you’ll be in a bunker. Enter the room on the left and come a little bit down toward the screen to find this note on a metal shelf.
  • Troubled Man’s Note 16 Just Me and Her – After turning the lights back on with electrical panel in the room with the previous note, walk out of this room. Go directly across the hall into a kitchen area. This note is found on a metal shelf toward the camera. It can be a little tricky, but just walk toward the screen and the camera will flip revealing this note on the shelf next to some water jugs.
  • Troubled Man’s Note 17 Business Card – Exit the kitchen and turn right. Follow the hallway up and turn right. Keep going until you see an open door on the left with a green light. Enter the room and straight across to find this card on a desk.
  • Troubled Man’s Note 18 Keeping Distance – Walk just a tad to right from the previous card to find this note on a bookshelf.
  • Troubled Man’s Note 19 Hypothesis – From the last collectible, head to the far end of this room and up the two yellow and black stairs. Here, you’ll find a Charlie Kelly/Pepe Silvia meme like board above a white table. Interact with it and look to the bottom left to find this note on top of a book.
  • Troubled Man’s Note 20 Alone – Leave this room and turn left. Head down the hallway and into the room with busted open door. Go over to the desk on the left side of the room with the butterfly pictures around it to pick the final collectible of the game.

caught the scent medium trophy achievement Caught the Scent

Find an Echo of a mysterious caller.

See “All That’s Left Unsaid” for more details and a full text guide of all collectibles.

followed the trail medium trophy achievement Followed the Trail

Find all of Henry’s Echoes in a single playthrough.

See “All That’s Left Unsaid” for more details and a full text guide of all collectibles.

spirit walking medium trophy achievement Spirit Walking

Spend 10 minutes outside your body.


In order to be outside of your body, you have to press and hold O/B while the screen is split. This will allow you to move around only in the other world. You’ll only have a limited amount of time that you’re allowed to be outside of your body like this. Press and hold O/B to return to yourself if you’re getting too close to disappearing because this can kill you. This is a mechanic that is used to solve puzzles, so you’ll probably unlock this without having to go out of your way for it. If you just want to get it out of the way and done with, hold O/B and walk around outside your body until you almost disappear. Return to your body. Just keep repeating that process until the Trophy/Achievement pops.

phantom medium trophy achievement Phantom

Escape the creature without alerting it.


This actually takes place over multiple encounters with the creature.

All you have to do is stay hidden and move when he’s not looking. Each of the sections are not very long or difficult.

After the fourth encounter, the Trophy/Achievement won’t pop until you pick up the bolt cutters and use them for the first time to exit through a door.

If you get caught and grabbed, don’t press “Continue.” Instead, quit and then retry. If you hit “Continue,” the game will log that you were caught and the Trophy/Achievement will be locked even if you make it through clean on the next attempt.

famished medium trophy achievement Famished Feline

Feed the cat in Jack’s apartment.


This Trophy/Achievement is earned right at the beginning of the game. There is a can of cat food on the counter in the kitchen of Jack’s apartment. Interact with the can with Square/X to pick it up. Just to the right from there is a cat bowl on the floor. Fill the bowl with the cat food. Make sure to do this before leaving downstairs.

edge of sanity medium trophy achievement Edge of Sanity

Acquire the razor.

The razor is needed to progress so that makes this an unmissable. This is found in the other world inside the hotel shortly after dropping through the hole in the ground on the 2nd floor in a bath tub full of blood. You will need to do an out of body experience to reach it.

 Cut the Crap

Acquire the bolt cutters.

This is needed to progress the story so that makes this an unmissable. You’ll pick these up after freeing the two souls of Nicholas and Tori.

 Through the Looking Glass

Use a mirror to cross over.

This is an unmissable story related Trophy/Achievement.

 Inner Investigator

Inspect 25 objects in a single playthrough.

See “Psychic Sleuth” for more details.

 Dual Detective

Inspect 50 objects in a single playthrough.

See “Psychic Sleuth” for more details.

psychic sleuth medium trophy achievement Psychic Sleuth

Inspect 100 objects in a single playthrough.


At first this may sound like a lot, but if you’re thorough, it’s really not. Anything in the environment that you can interact with by pressing Square/X will count as an inspect-able object.

Inspect everything you see. There are more than 100 items to inspect, so just comb through each area pressing Square/X on everything you can. I actually had the Achievement “Inner Investigator” done before I even gave the tie clip to Jack in the beginning. So, there are more than enough objects to inspect for this.


Defeat the creature in the flooded ruins.

This is an unmissable story related Trophy/Achievement.

 Medium Rare

Burn through the moths using Spirit Shield.

This is needed to progress the story so that makes this an unmissable. This popped for me during the second hallway of moths. You’ll place a sunflower in a vase in order to gain enough Spirit Shield. Leave that room and head down the hallway. Hold RB to bring up your shield and walk through the moths.


Use Spirit Blast to create electricity.

This is an unmissable story related Achievement. You’ll unlock this as you follow the girl in the tunnel to the Niwa building. You’ll have to use a Spirit Blast to open a locked gate.

 Running Sim

Run 2 kilometers.

This is something will eventually pop as you play through the game. This is another accumulative Trophy/Achievement. Hold L1/LT to run.

 The Last Goodbye

Send Jack’s spirit away.

This is an unmissable story related Trophy/Achievement.

 Welcome to Niwa

Reach the hotel.

This is an unmissable story related Trophy/Achievement.

 The Cheerful Kind

Meet Sadness.

This is an unmissable story related Trophy/Achievement.

 You Saw, You Ran, You Lived

Survive a monstrous encounter.

This is an unmissable story related Trophy/Achievement.

 The Childeater

Experience your first vision of Thomas.

This is an unmissable story related Trophy/Achievement.


Send the Childeater away.

This is an unmissable story related Trophy/Achievement.

 Among the Ashes

Find the Red House.

This is an unmissable story related Trophy/Achievement.

the hound medium trophy achievement The Hound

Experience your second vision of Thomas.

This is an unmissable story related Trophy/Achievement.


Send the Hound away.

This is an unmissable story related Trophy/Achievement.

the pact medium trophy achievement The Pact

Uncover the mystery of the burned down house.

This is an unmissable story related Trophy/Achievement.

dark water medium trophy achievement Dark Water

Make it through the pump station.

This is an unmissable story related Trophy/Achievement.

mirror mirror on the wall medium trophy achievement Mirror, Mirror on the Wall

Complete the broken mirror.

This is an unmissable story related Trophy/Achievement.

cant always save everyone medium trophy achievement Can’t Always Save Everyone

Finish the game.

This is an unmissable story related Trophy/Achievement.



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