In her 2010 book, What I Cannot Change, Rimes explained the confessional song "comes from a place where I allowed myself to be vulnerable yet strong at the same time. It's about my learning about forgiveness, acceptance of myself, and a higher will other than my own. It's about my understanding of where, when, and how to stand up or not to stand up for myself."
In February 2009, a dance re-mix of this song climbed to #1 on the Hot Dance Club Play chart. This meant that Rimes became the first ever artist to top both the Billboard Country and Dance charts.
Rimes' team created a website named after the song (whaticannotchange.com) where fans could share stories about the situations they had to confront in their own lives and the realizations about what they could and couldn't change. She eventually abandoned that domain and redirected it
Rimes co-wrote every track on Family, her 12th studio album, which was a first for the country singer. "What I Cannot Change" was one of many tunes on the release co-written by Darrell Brown, who went on to produce her next few albums. In her book, Rimes recalled how she poured her heart out to Brown over the difficulty of keeping people in her life who weren't willing to grow along with her and the guilt she felt about leaving them behind. Brown, who was taking notes of their conversation, encouraged her to put her feelings into song.
"We put these heartfelt outpourings into verses and we stepped away for a couple of weeks, still not realizing where this song was leading us," she explained. "Darrell and I got back together after a few weeks, and once again I had an overwhelming revelation: I had to let go of the things that I couldn't change about other people in my life; the things that I couldn't change about myself; and start figuring out how to love myself and other people, even with all their faults. This revelation felt like a floodgate opening up, and emotions were pouring out of me."
Rimes sings about her difficult relationship with her parents, whom she admits she doesn't know well enough. When asked if their divorce, which occurred when the singer was 14, was the main issue that inspired the song, Rimes replied: "For a long time, even though I was thought not to blame myself, I think deep, deep down there was a part of me that did. And that's something that I've struggled with and has affected my life in so many different ways. I'm finally started to let go of that and breaking out of blaming myself and I think that's a huge turning point for me as a woman. So, yes it's something that I deeply struggled with even more than I ever knew until recently and because I'm able to let go of it now and changing those tings I'm realizing how deeply it did affect me."
This earned Rimes a Grammy nomination for Best Female Country Vocal Performance in 2009, but she lost to Carrie Underwood for "Last Name
The chorus is loosely based on the Serenity Prayer. The most common version, popularized by Alcoholics Anonymous and other 12-step programs, reads:
God, grant me the serenity to accept the things I cannot change,
courage to change the things I can,
and wisdom to know the difference.
This was used in the 2009 movie Like Dandelion Dust, starring Mira Sorvino.