Prepare the cabbage: Remove any tough outer leaves from the cabbage. Cut it into quarters, remove the core, and then slice into large shreds or chunks. They will cook down a lot in the slow cooker.
Layer in the slow cooker: Add the chopped cabbage to the bottom of a 4- to 6-quart slow cooker. Scatter the sliced smoked sausage over the top.
Add seasonings and dairy: Sprinkle the salt and pepper over the cabbage and sausage. Pour the heavy cream evenly over everything, then dot the top with the cream cheese cubes so they’re spread out.
Cook low and slow: Cover and cook on LOW for 4–6 hours, or on HIGH for 2–3 hours, until the cabbage is very tender and the sausage is heated through. The exact time will depend on your slow cooker and how full it is.
Stir to make it creamy: About 15 minutes before serving, give everything a good stir. The cream cheese will melt into the cream and cabbage, creating a rich, creamy sauce. Taste and adjust salt and pepper if needed.
Serve warm: Ladle the creamy cabbage and sausage into bowls. If you like, finish with an extra crack of black pepper on top. Serve hot and enjoy while the sauce is silky and the cabbage is tender.