It might seem to be controversial because all the statements look alike though, but if you read the excerpt properly you will understand which of these options embraces the meaning of all of them and reveals the general idea. Definitely, Ivan Ilyich feels lonely, and his childhood memories cause him more pain - is the most accurate summary of the excerpt shared above, at least because during his internal dialogue, Ivan Ilyich mentions "No, I mustn't think of that (childhood)....It is too painful".
