The album is split into two CDs: Elephants, featuring a darker, more vulnerable and intimate tone, which is said to be more similar to Yamagata's debut, Happenstance; while ...Teeth Sinking into Heart, shows a grittier, more cynical side of the artist, who has described it as "this mix of Pulp Fiction surf guitar, PJ Harvey [and] Tom Waits-flavored rock tunes which would be great to play live but ... just developed into this entity that would break the beauty of (Elephants).

"[1] The album contains fifteen tracks (one of them hidden), ten appearing in the first disc, Elephants, and five in ...Teeth Sinking into Heart.

Most of the album was produced by Mike Mogis, known for previous works with artists such as Bright Eyes, Rilo Kiley, and The Faint, among others.

On October 9, 2008, a two-song live acoustic video performance premiered on LiveDaily Sessions, featuring the songs "Faster" and "Sunday Afternoon".

In a glowing review, Andrew Leahey of Allmusic called Yamagata "one of the strongest songwriters to emerge during the early 21st century" while praising the song "Elephants" for its lyrical intensity.

He commented that Elephants is "a hushed mood piece that's all wet vowels and damaged love" and ...Teeth Sinking into Heart is "filled with rock & roll bite and gloves-off verses" while stating that Yamagata had pushes past familiar singer-songwriter fare into bolder regions with the album.