Tolstoy's Ilyich: Disguised anxiety and internal conflicts

Literature has this unique feature of offering us a safe space to experience emotions and to identify with the characters we read about. In this article, we are going to explore Ivan Ilyich – the main character of Tolstoy’s novel “The Death of Ivan Ilyich”. The novel is considered one of the finest examples of literature dealing with the topic of meaning.


This analysis aims to shed some light on how anxiety and internal conflicts are linked. We will explore how counselling can help us explore our internal conflicts and anxieties and how bringing these two into awareness can help us live a more meaningful life. 

Anxiety and internal conflicts

In the last part of his life, Ivan Ilych is faced with the realisation that most of his life he engaged in some sort of social illusion, where if you don’t fit the narrative and don’t embrace your social role, you will be marginalised. At the end of his life, he is faced with the fact that a sick struggling man, whose condition forces the reality of pain and death on those around him, is not wanted around. 

From the moment his sickness starts to impact his life, Ivan starts to understand how most people prefer the fantasy of a happy endless life and are not willing to put up with the ugliness of suffering and death. Not that they would believe in endless life, on an abstract level they accept death, but their own anxieties make them avoid or reject any signs endangering the illusion. In a way, this is an application of the old saying “out of sight, out of mind” – well, at least out of the conscious. 

Ivan experiences an internal conflict; he catches himself not accepting his pain. There is a part of him that wants to entertain that fantasy of “all is well” and avoid the anxiety associated with the thought of having lived a meaningless life. But there is also a part that longs to express his real feelings and pains. This conflict makes everything worse – Ivan is forced to deal with the physical pain and, on top of that, he needs to put on a mask pretending all is good. He desires from the bottom of his heart to stop the lie, but he is compulsively continuing to play a part in it. We can shortly see how rejection anxiety shapes his behaviour and how it is related to carrying on this lie. 

There is a feeling of prohibition: the truth that everyone is aware of should not be voiced. When his brother-in-law visits him, Ivan overhears a conversation between his wife and his brother-in-law: “Don’t you see – he’s a dead man, look in his eyes. No light. What’s wrong with him?”. Ivan becomes aware of this and voices these thoughts to himself: “This is not a matter of the appendix or the kidney but of life and…death. (…) Yes, why deceive myself? Isn’t it obvious to everybody except me that I’m dying, and it is only a question of the number of weeks, days – right now, maybe. (…) Death. Yes, death. And none of them knows or wants to know, or feels pity. They’re playing.”

A couple of pages later this is summarised brilliantly. The emphasis falls on the painful experience of not being allowed to express what he was experiencing and others refusing to acknowledge it: “and he was tormented by that lie, tormented that no one wanted to acknowledge what they all knew and he knew, but wanted to lie to him about his terrible situation, and wanted him and even forced him to participate in that lie. The lie, this lie, perpetrated upon him on the eve of his death (…) was tormenting for Ivan Ilyich (…) many times, as they were performing their tricks over him, he was a hair’s breadth from shouting at them: Stop lying! You know and I know that I’m dying, so at least stop lying”.

But why is he not rebelling against this lie that he now perceives? Because, at a deep level, he is aware of the rejection that would accompany this rebellion. His fear of rejection confines him. On the one hand, he can perceive reality and voice these thoughts for himself, so there is a moment of inner sincerity. But the fear of rejection is stopping him from voicing out loud these thoughts and accompanying anger

Relationships’ impact on anxiety and internal conflicts

This whole charade becomes even more painful when there is an opportunity to experience what genuine and honest interactions look like. Ivan is blessed with a carer like Gerasim. The contrast between the interactions with his family and old friends, on one hand, and Gerasim, on the other, becomes stark. “Only Gerasim understood the situation and pitied him. Therefore, Ivan Ilych felt good only with Gerasim (…) Gerasim alone did not lie, everything showed that he alone understood what it was all about and did not find it necessary to conceal it”. There is no fear of rejection with Gerasim and that gives a sweet flavour to that interaction, the flavour brought up by honest expression of feelings. Around Gerasim, Ivan has the possibility of dropping the mask. Ivan wants others to accept his suffering and show care and love, to be honest about the death that is closing in, rather than pretending – the physical pain would be there but not needing to lie would alleviate the suffering. 

There is another instance where we get to observe the internal conflict. His entire life is built on appearances and everyone around him (except Gerasim) wants the show to go on. Therefore, despite the obvious, nothing will be mentioned and any attempt to point out the obvious will be ignored or punished, depending on who expresses them. They want an Ivan who is doing well, and Ivan gives in and joins the pretence – he feels the compulsion to do so, otherwise, his anxiety will become too much.

At this point, the mechanism of aligning to what is socially expected is so ingrained in his personality that he doesn’t even realise it is anxiety that drives the behaviour. But his longings for closeness are so intense. He gets an authentic interaction with Gerasim, who has absolutely no intention of seeing Ivan other than how he is – suffering: “No one pitied him as he wanted to be pitied (…) when Ivan wanted most of all, however embarrassed he would have been to admit it, to be pitied by someone like a sick child. He wanted to be caressed, kissed, and wept over, as children are caressed and comforted. He knew that he was an important judge and, that he had a greying beard, and that therefore it was impossible; but he wanted it all the same. And in his relationship with Gerasim, there was something close to it, and therefore his relationship with Gerasim comforted him.”

The continuation of this passage sheds light on the internal conflict Ivan is experiencing with others outside his family. The conflict reflects two sides at war within himself – the definition of psychological internal conflict – one part engages in the lie and wants to carry it on, and the other part wants to be allowed to express true emotions: “Ivan wanted to weep, wanted to be caressed and wept over, and then comes his colleague, the judge Shebek, and instead of weeping and caressing, Ivan makes a stern, serious profoundly thoughtful face and, by inertia, gives his opinion on the significance of a decision of the appeals course and stubbornly insists on it. This lie around and within him poisoned most of all the last days of Ivan’s life”. 

The last realm where the social illusions are at play is in the interactions with doctors. He starts to realise that doctors are incapable of helping him and it is all a show, a script. The doctor pretends he knows what he is doing, and the patient accepts the doctor’s diagnosis – although he knows very well this is not going to help. But unspoken social rules prohibit authentic behaviour: “….and demanded that he go to a famous doctor. He went. It was all as expected; it was all as it is always done. The waiting, the assumed doctorly importance familiar to him, the same that he knew in himself in court, and the taping and the auscultation and the questions asking for pre-determined and obvious unnecessary answers, and the significant airs, which suggested that you have to submit to us, and we will arrange it all (…). It was all exactly the same as in court. As he put on airs before the accused in court, so the famous doctor put on airs before him”.

Ivan notices the similarities between his behaviour – in court, as a magistrate – and the doctor’s. He knows all too well the rules of engagement, he knows that authenticity and expressing real feelings or thoughts are not allowed or will be met with punishment. His attachment to these “rules of engagement” is so entrenched in his way of perceiving the world that going against them would trigger an overwhelming feeling of anxiety: “For Ivan only one question mattered: was the condition dangerous or not? But the doctor ignored the inappropriate question. (…) And this conclusion struck Ivan painfully, calling up in him a feeling of great pity for himself and great anger at this doctor, who was so indifferent to such an important question”.

In this final instance, we get a feeling of how powerful a gripping anxiety can have on someone, so strong that despite knowing death follows and none of these things will matter in the ultimate reality, the person’s behaviour is still shaped by anxiety and, in this case, rejection anxiety.  

How can counselling help? 

Counselling can help you explore your internal conflicts in a safe space and understand the role anxiety is playing in your life. In the work with my clients, out-of-awareness internal conflicts and underlying anxiety are some of the things that come up time and again.

You can think about internal conflict as a fight between internal parts within the individual that are usually pushing in opposite directions. Since these are usually opposite forces – i.e. to do and not to do – there is no middle ground. Both options carry with them a potential danger and a potential reward. It is this conflict between potential punishment and rewards that raises anxiety in the individual. There is hope for something better and there is fear of something worse. As an example, there might be a hope for a more independent life and a fear of loneliness, of being rejected by others if voicing your true thoughts or feelings in a given circumstance.

In counselling, you have the chance to explore the parts involved in the conflict and bring the conflict and the anxiety from unconsciousness into awareness. Then you can understand which course of action serves you best. Probably none of them is perfect – they all carry with them risks, otherwise, there will be no conflict. However, it will be you who analyses and decides rather than feeling like being driven into a given course of action without realising why. Ivan felt he didn’t want to play a part in the lie. But his anxiety of being rejected and being less than himself and others expected him shaped his behaviour in such a way that he was never able to push back and voice his feelings and thoughts.

If you are experiencing anxiety and you want to explore your internal conflicts in a safe, supportive environment, get in touch or book an introductory call to find out more about how I work. 

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The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Surbiton KT6 & Central London EC4Y
Written by Robert Preda, BSc. Psychology, MNCPS Accred, ACC, BPS | Counsellor
Surbiton KT6 & Central London EC4Y

Robert Preda is a Transactional Analysis Counsellor, based in London.
The series entitled "Literature, Life and Therapy" aims to draw parallels between the inner world of fictional characters and our everyday experiences. Learn about them and you'll learn about yourself!
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