You're the grown up now.
No offense taken. It's not meant to be warm and fuzzy at all. It's a very personal piece symbolizing some of the less commonly acknowledged feelings and experiences of motherhood. The tiny people climbing up her hair symbolize her dependents. The tiny child inside the broken skull is the mother's former child self that still exists inside her, frightened and wide eyed at the adult responsibilities she faces. The mother's face reflects the horror of discovering that just because you're grown up with adult responsibilities doesn't mean you don't still feel like the helpless child you were before at times. The straight jacket symbolizes the even more personal experience of being a mother whose everyday concerns are compounded by the constraints of an unjust legal system forcing her to cooperate with an abuser or risk losing her children to him. The pearl skull is representative of the remarkable beauty and strength that her struggle has brought out in her.