Praskovya Fedorovna came of a good family, was not bad looking, and had some little property. Ivan Ilych might have aspired to a more brilliant match, but even this was good. He had his salary, and she, he hoped, would have an equal income. She was well connected, and was a sweet, pretty, and thoroughly correct young woman. To say that Ivan Ilych married because he fell in love with Praskovya Fedorovna and found that she sympathized with his views of life would be as incorrect as to say that he married because his social circle approved of the match. He was swayed by both these considerations: the marriage gave him personal satisfaction, and at the same time it was considered the right thing by the most highly placed of his associates. (2.15-16)
It doesn't sound as if Ivan Ilych is madly in love with Praskovya Fedorovna. It's more like he marries her because other people tell him it's a good thing to do and he doesn't have any objections. What he likes about her are her external qualities – she's got some money, and she's what a good wife is supposed to be.
The preparations for marriage and the beginning of married life, with its conjugal caresses, the new furniture, new crockery, and new linen, were very pleasant until his wife became pregnant – so that Ivan Ilych had begun to think that marriage would not impair the easy, agreeable, gay and always decorous character of his life, approved of by society and regarded by himself as natural, but would even improve it. But from the first months of his wife's pregnancy, something new, unpleasant, depressing, and unseemly, and from which there was no way of escape, unexpectedly showed itself. (2.18)
Ivan thinks of his marriage and his family primarily in terms of himself. It's supposed to give him pleasure. He's not at all prepared to face the challenges of living with and caring for another person.
His wife, without any reason – de gaiete de coeur as Ivan Ilych expressed it to himself – began to disturb the pleasure and propriety of their life. She began to be jealous without any cause, expected him to devote his whole attention to her, found fault with everything, and made coarse and ill-mannered scenes. (2.19)
It's unclear what ultimately changes Praskovya Fedorovna mood. Is it just the added moodiness that can come with pregnancy, or is it something else? We might wonder whether Praskovya Fedorovna doesn't have good reason to be upset. It sounds as if her main complaint is that she's not getting enough attention from Ivan. We can't quite tell whether the narrator is representing things from his own perspective or from Ivan's. It sounds like it might be the latter.
With the birth of their child, the attempts to feed it and the various failures in doing so, and with the real and imaginary illnesses of mother and child, in which Ivan Ilych's sympathy was demanded but about which he understood nothing, the need of securing for himself an existence outside his family life became still more imperative. (2.20-21)
Ivan Ilych doesn't appear to have any sympathy for his wife or his newborn child. Instead, they're a bother to him, and interfere with his ordered and pleasant life. All he wants to do is retreat from his house. This mirrors the way he will himself be treated by his family once he becomes sick.
Things went particularly well at first, before everything was finally arranged and while something had still to be done: this thing bought, that thing ordered, another thing moved, and something else adjusted. Though there were some disputes between husband and wife, they were both so well satisfied and had so much to do that it all passed off without any serious quarrels. When nothing was left to arrange it became rather dull and something seemed to be lacking, but they were then making acquaintances, forming habits, and life was growing fuller. (3.20)
Home-decorating is apparently the only thing that can bring Ivan Ilych and Praskovya Fedorovna together. That hardly amounts to rebuilding a relationship. They stop fighting once they get to St. Petersburg only because what they each want out of city life happens to coincide. They both want to make new friends, they both want to have a nice home with which to impress people. As for actually caring about each other, well…
Having come to the conclusion that her husband had a dreadful temper and made her life miserable, she began to feel sorry for herself, and the more she pitied herself the more she hated her husband. She began to wish he would die; yet she did not want him to die because then his salary would cease. And this irritated her against him still more. She considered herself dreadfully unhappy just because not even his death could save her, and though she concealed her exasperation, that hidden exasperation of hers increased his irritation also. (4.2)
And we hit an all-time low. This might be the first hint that Praskovya Fedorovna actually wants Ivan to die. She blames him for all that's wrong in her life and hates him for making her suffer. We already know he's incapable of showing her sympathy, so to some extent she has reason to be angry. But we've got to ask – does she really only care about Ivan for the money, or is this just a thought she has in the heat of a moment?
Praskovya Fedorovna's attitude to Ivan Ilych's illness, as she expressed it both to others and to him, was that it was his own fault and was another of the annoyances he caused her. Ivan Ilych felt that this opinion escaped her involuntarily – but that did not make it easier for him. (4.22)
The tables are turned. Now Ivan is the one suffering, and Praskovya Fedorovna is the one who doesn't show him any sympathy. She looks at him as unreasonable for not following doctor's orders. This might mirror how Ivan thought she was unreasonable for demanding his attention. In each case, the one refuses to take the other seriously. The reversal will become even more complete once Ivan is the one homebound (just as his wife was homebound when she was pregnant).
This meant calling in the famous specialist, regardless of expense. He smiled malignantly and said "No." She remained a little longer and then went up to him and kissed his forehead.
While she was kissing him he hated her from the bottom of his soul and with difficulty refrained from pushing her away. (5.31-32)
What do you make of Praskovya Fedorovna's kiss? Is there anything genuine about it, or is it just done for show? The narrator gives us no clues. All we know is that it feels false to Ivan and he hates her for it. He can't even take a simple expression of affection from his wife seriously anymore. Here too it's hard to tell how much of the problem is Praskovya Fedorovna and her falseness and how much of it is Ivan, refusing to even consider that there might be something genuine in her.
She would have gone away, but just then their daughter came in and went up to say good morning. He looked at her as he had done at his wife, and in reply to her inquiry about his health said dryly that he would soon free them all of himself. They were both silent and after sitting with him for a while went away.
"Is it our fault?" Lisa said to her mother. "It's as if we were to blame! I am sorry for papa, but why should we be tortured? (11.4-5)
Because the narrative centers on Ivan it's easy to adopt his point of view, and in his point of view his family is not so great. They don't care for him, and find him only an irritation that they'd rather have off their hands. But Lisa raises a good point. To what extent are their relations bad at this point because Ivan keeps pushing them away and treating them cruelly?
At that very moment Ivan Ilych fell through and caught sight of the light, and it was revealed to him that though his life had not been what it should have been, this could still be rectified. He asked himself, "What is the right thing?" and grew still, listening. Then he felt that someone was kissing his hand. He opened his eyes, looked at his son, and felt sorry for him. His wife came up to him and he glanced at her. She was gazing at him open-mouthed, with undried tears on her nose and cheek and a despairing look on her face. He felt sorry for her too. (12.7)
This is the transformative moment, when Ivan genuinely cares about his family for the first time. For the first time he's not focused on his suffering and how they make it worse, but on the suffering he causes them. It's clear that Vasya, Ivan's son, cares for him. But here's Praskovya Fedorovna crying too. Does she care for him? How does that jive with the way she comes across in the first chapter?