Frome is internally conflicted because he knows that he cannot just abandon Zeena and elope with Mattie. Zeena is an unpleasant person, querulous and irritable, and Ethan doesn't love her. But she's also ill, though the nature of her illness might be psychological. She is manipulative as well, perhaps because she senses Ethan has little feeling for her. His own conscience or inner self prevents him from taking the step with Mattie he dreams of taking. This was a time when people couldn't just leave their spouse, file for a no-fault divorce, and then assume that, in spite of the immediate turmoil this would cause, all would turn out for the best and each party would find a new life and a new partner and then live happily ever after. In the nineteenth and early twentieth centuries, things didn't work that way. Ethan and Mattie both feel trapped, and the outcome is that they essentially destroy themselves.

But externally, the conflict is a mirror of this. The impracticality—financially and otherwise—of abandoning his homestead and fleeing west (or anywhere other than Starkfield) with Mattie is just as much an impediment as his inner turmoil. Ironically, and tragically, after the "smash-up," these conflicts are simply intensified, and for all time. For the remainder of his life, Frome, crippled himself and now even more impoverished than in the beginning, is trapped in a world of perpetual inner anguish, emptiness, and guilt. He's trapped as well in circumstances of external horror, having to live with a woman he does not love. The other woman, whom he does love, is paralyzed for life.

As what has been termed a "study in frustration, loneliness, and moral responsibility," Edith Wharton's Ethan Frome presents several conflicts for Ethan Frome, both internal and external:

External conflicts

• Ethan's first major conflict derives from his desire to be an engineer and leave Starkfield for a city where he can go to museums and places where his intellectual needs are met.
• As a Naturalistic novel, the environment of Ethan mirrors his conditions and the harsh winter and milieu in which Ethan lives conflict with his youthful desire to leave as well as his attempts to leave the farm for which he is in debt.
• The novel ends with the final external conflict of Ethan imprisoned for the rest of his life with the tragic results of his and Mattie's suicide attempts. 
• The external conflict that is central to the narrative is the love triangle among Ethan, his wife Zeena, and Mattie Silver. This conflict reaches a climax when Zeena, "a hundred times bitterer and more discontented than when he had married her," returns from Bettsbridge and discovers the broken pickle dish, symbolic of the fractured relatioships. Informing Ethan that her doctor has told her she is "a great deal sicker than you think," Zeena has made plans for Mattie to be replaced by a hired girl, who will arrive the next day. This disastrous news turns the love affair of Mattie and Ethan to tragic proportions and they despair of any happiness together.

Internal conflicts

• Because of his father's death and his mother's illness, Ethan wrestles with his sense of moral responsibility and his desire to get away from the cultural and intellectual deprivations of Starkfield.

His father's death, and the misfortunes following it, had put a premature end to Ethan's studies; but though they had not gone far enough to be of much practical use they had fed his fancy and made him aware of huge cloudy meanings behind the daily face of things.

• Since he is already married, Ethan also wrestles with his emotional and physical feelings for Mattie Silver.  In this conflict, Ethan's passion is controlled to a few embraces and kisses because of his strong moral sense.
• After Zeena informs Ethan that Mattie must go, "[C]onfused motions of rebellion stormed in him." In the rising of his "instincts of self-defense," Ethan considers going West and telling Zeena to sell the farm.  But, he halts as he realizes that if he gives his wife the farm, he will be left with nothing on which to start when he reaches the West.  Also, he considers Zeena's fate since the farm is yet mortgaged. His subsequent plan to ask money from the Hale's on false pretenses also terminates in Ethan's strong sense of morality. He ponders,

There was no way out--none.  He was a prisoner for life, and now his one ray of light was to be extinguished

• Ethan's final internal conflict involves his dilemma of whether he should commit suicide with Mattie.
• The internal conflict that is the most important is Ethan's struggle with his conscience and sense of moral obligations.