Insight is gained as the player progresses through the game, defeats enemies, and finds new areas.
- Entering a boss area for the first time grants +1 Insight.
- Entering Iosefka's Clinic through the back door grants +1 Insight.
- Entering the Abandoned Old Workshop grants +2 Insight.
- Entering Yahar'gul, Unseen Village after being killed by a Kidnapper grants +1 Insight.
- Entering the Cainhurst Castle grounds grants +2 Insight.
- Defeating a boss grants +3 Insight.
- Defeating a boss in another player's world grants +1 Insight.
- Consuming a Madman's Knowledge grants +1 Insight.
- Consuming a Great One's Wisdom grants +2 Insight.
- Consuming a Blood Dreg grants +1 Insight.
- Consuming One Third of Umbilical Cord grants +3 Insight.
- Sending an NPC to Iosefka's Clinic or Oedon Chapel grants +1 Insight.
- Killing an adversarial host player grants +1 Insight.
- Talking to Master Willem for the first time grants +2 Insight
- Examining the guard at the entrance to Byrgenwerth grants +2 Insight
The maximum insight attainable is 99. Afterward, doing an action that would normally increase Insight does nothing (consuming a Madman's Knowledge or Great One's Wisdom simply uses the item but provides no benefit).
Insight can be spent / lost in the following ways:
- -1 Insight after using the Beckoning Bell or Sinister Resonant Bell,
- Buying items from the Insight Messengers (requires one (1) Insight to access).
- Certain enemies can steal Insight (Not recoverable).
Higher Insight levels will increase the difficulty of the game because enemies will gain new and more powerful attacks. Fifteen (15) Insight is the minimum requirement for new attacks (and one new enemy) to appear. The player's vulnerability to Frenzy will also increase drastically.
At least one Insight is needed for the Doll to become active for the first time. She will become inanimate if the player's Insight level drops to zero again, but she can still be interacted with in order to level up.
At a current level of 20 Insight, Winter Lanterns can be heard singing.
At a currently unknown level of Insight, the doorkeeper guarding the entrance to Byrgenwerth can be heard rambling about a beast bite and the door.
After 60 Insight, the sound of a baby crying will follow you wherever you go.