Also: If I'm reading this correctly, Know My Pain grows weaker as you level. At 10 level and later, it will empty your insanity every time, whereas before that it just slowly drains it. Unless that's the point, but i'd doubt that.
As for Clouded vision, i'm skeptical. Although the flavor is great, it becomes a liability, and a harsh one at that. Second, if it is to be gained at level 2, people will actually dread the level, which isn't good. It needs to either offer something in return or be "gained" at level 1. Bonus points if it is offset as you level, in a "learning to control it" way (such as increased tools to not attack). Finally, as a tank, i think you'll be relying on reach and AoO, so this is really dangerous as is, possibly crippling.