The album takes inspiration from the Dutch artist Vincent van Gogh for Mitchell's self-portrait on the cover.

The song "Turbulent Indigo" references van Gogh, while describing the mental turmoil both he and Mitchell face in the creative process.

The song "Not to Blame" was rumored to be about Mitchell's fellow singer-songwriter and former lover Jackson Browne, who was alleged to have beaten his girlfriend, actress Daryl Hannah.

Similarly, the song "Sex Kills" referenced a number of late 20th century topical issues, including violence, AIDS, global warming and consumerism.

Q's Tom Doyle called the album a "welcome return to the atmospherics and acoustic terrain she's best known for", further writing that "The majority of the tracks here recall the wafting soundscapes of 1976's Hejira, with gentle, controlled feedback, Pastorius-styled bass, Wayne Shorter's tumbling saxophone patterns and walls of acoustic guitars providing a dramatic backdrop for Mitchell's bold lyrical imagery.