I believe the piece is just about how people in life will expect you to smile under harsh conditions, and sometimes inflict emotional pain on you (the emotional being represented physically in this film). And while people may cause you to feel as you do, they're often quick to disregard your inner thoughts/feelings to hold the crude expectation that you should cast an image of happiness, whether it be a facade or not - just to fit in with social standards.
The imagery that is being presented is just taking the concept of expectational well-being and putting it into a heavily stylised and 'actual' interpretation. If that makes sense. Well that's all from me. Brilliant work!
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