Final answer:
Macbeth's main issue as king is intense guilt and paranoia, stemming from his heinous deeds. This leads to psychological distress and a series of further crimes driven by fear of losing power. Thus, the correct option is C) Guilt and paranoia.
Step-by-step explanation:
Macbeth's rise to power as the King brings with it an array of challenges. However, the main problem he faces, according to his own reflections, is not excessive power or lack of ambition. Compassion for the people is also not his concern. Instead, Macbeth deals with intense guilt and paranoia. This issue permeates the play, as Macbeth struggles with the consequences of his actions - the murder of King Duncan and others. This guilt manifests as haunting visions and disturbed sleep, revealing the psychological turmoil that Macbeth experiences.
His guilt is further compounded by paranoia, as he fears losing the throne he has usurped. Macbeth's troubled state is evident in his erratic behavior and distrustful nature, leading him to commit more crimes to secure his position.
The passage from Macbeth speaks to this inner turmoil, 'The service and the loyalty I owe, In doing it, pays itself. Your highness' part Is to receive our duties; and our duties Are to your throne and state children and servants, Which do but what they should, by doing every thing Safe toward your love and honour.'
These lines show Macbeth's awareness of his duties and hint at an internal conflict between what he owes in loyalty and what he has done to achieve his status.
In summary, the correct option that reflects Macbeth's main problem since becoming king is C) Guilt and paranoia.