Echoes are collectibles in The Medium that provide backstory to its overarching plot. If you are near one, you will hear whispers that help to guide you to its item’s location. Once you inspect it, rotate it using the right thumbstick on your and activate your Insight ability using left bumper to find the Echo. Holding the item in place for a few seconds will uncover it and give you details on what has happened at the Niwa Hotel.
There are 28 in total, and finding them earns you the Calling Out to Me achievement, which is worth 40 Gamerscore. However, you must locate them all in a single playthrough to earn it, so read on for every Echo location.
The first Echo is found by the entrance steps to the Niwa Hotel. Look for its booth at the bottom of the steps.
Once inside the Niwa Hotel, look to your left for some abandoned clothes and a briefcase. Interact with the pile to locate the shoe.
After your first encounter with a moth swarm. Head down the corridor and use your Insight ability to unearth a handprint on a door to your left. Use your Out of Body Experience ability to head inside and grab a key on the table. Return to your real world self and walk back down the hallway.
There is a locked door next to the moth swarm. Open it and walk through the bathroom immediately to your left.
Take a right at the end of the hallway to find the phone on a desk.
Prescription pill container
In a room where the exit is blocked by a moth swarm. It’s the same room where you have to restore power to a Spirit Well. Head to the bathroom behind the dividing wall and look at the sink to find the container next to a Mentor’s Diary page.
In the room where you find the razor. From the razor’s location, walk across the room into the bathroom and look at the mirror.
In the empty swimming pool as you look for a way into the Dayroom Center. Drop down into it using the Y button and head to the back left corner.
Exit the pool to your left and look at the debris on your right.
After squeezing through a gap in a wall, look for a pile of clothes on the floor next to a bench and some lockers.
After you see Sadness in a mirror portal that you can’t access yet. Head out of a door to your left and, before you drop down towards the pool again, head left to a dead end to find the toy.
Follow the spirit trail from the locker you just opened. It will take you back to the empty pool. Drop down to find the toy by some rubble.
Teddy bear one
Follow the trail across the pool and climb out. The bear is on a chair surrounded by debris.
Follow the trail one final time back into the shower room. Move the trolley out of the way to grab the toy.
After your first encounter with The Maw in the real world, head into the room that leads to the examination area and look for a wall-mounted phone.
As you look for the face mask for the ballerina’s spirit, inspect Vivienne’s autograph cards on a desk in her manager’s office.
In the conference room as you search for another spirit’s face mask. After you exit the mirror portal into this room, follow the path down the right hand wall and look for it on a desk.
In the room where the vote takes place. Walk down the right path past the table and chairs, and look for a desk with an ashtray on it.
After you exit the mirror portal back to the real world, grab the bolt cutters from the left side exit. Head back into this room and take the right exit. The wheelchair is in the next examination room.
After a cutscene with Sadness that leads to the Dayroom Center. Cut the skin door with the razor and hang left along the cabinets. Look for a box on a small table and inspect the drawing.
Inside the teacher’s room after you obtain its key. Head to the locked door by the flower and butterfly mural and open it. Walk forward and pick up the pen case on a table.
As woodland section begins. Head down the steps and take a left once you are on a narrow path. Follow the side path around to another telephone booth.
After a cutscene with Sadness, walk past the swing towards a small rock on your left. The cigarettes are on top of it.
From the cigarette pack, turn around and look for the wheel by some rubble.
From the wheel, head into the building behind you. Look for a carved horse on top of a counter to your left.
Head into the garage at the back of the workshop. Look for the recorder on the floor among some knocked over wood.
From the recorder, turn left and interact with a suitcase on top of a counter.
Teddy bear two
Inside the basement of the Red House. After you dropped down the destroyed stairs, head left towards some boxes. The bear is sitting on them.
From the bear, continue walking forward to find the needle on a shelf.
The final Echo is found on another shoe. Turn around from the needle, and walk down towards more boxes at the bottom of the screen. There should be a wall with a gap in it on Marianne’s left if you are looking directly at this object.