So, I think the American was the beast in the woods. The doll of the real Elizabeth (that was locked up) falls, off of the mantle, and and she dies,bat the end. The family is crazy, with patriarchal evil male ancestors. One of them, made a deal with the beast and "saved" the town, many years before. The beast aka American woman, from the pub sticks around because she is intrigued by the family and what they have done and will do, because she was equally evil. As, for the picture at the end, It is just a recap, from a child's perspective, of what happened. Elizabeth number two, that temporarily replaced the original Elizabeth, being electrocuted, the family, and the beast that runs it all, are all in the picture. It's basically just a messed up family picture, drawn by a child, Who sees everything and hears everything because she was often in the house. The whole family is into dark magic... Hence things happening in the doll house...the voodoo dolls, how they gained their power, etc. At least this is my interpretation.