In a large skillet over medium-high heat, brown the 1 pound Breakfast Sausage, breaking it up with a spatula as it cooks. Cook until no pink remains.
If your sausage is very lean (like turkey sausage), add 1 tablespoon Butter or bacon fat before the meat.
Reduce the heat to medium-low. If there is a lot of excess grease, you may drain off a little, but leave some for flavor. Add the cubes of 6 ounces Cream Cheese, 1 teaspoon Salt, 2 teaspoons Black Pepper, and 1 teaspoon Garlic Powder (if using). Stir constantly until the cream cheese is fully melted and incorporated into the sausage and fat.
Pour in the 1 cup Heavy Cream and the 1/2 cup Water(or broth). Stir constantly, scraping up any browned bits from the bottom of the pan—this adds great flavor!
Bring the gravy to a gentle simmer over low heat. Continue to stir occasionally. It will take about 5–8 minutes for the mixture to fully thicken. As the heavy cream heats and the cream cheese fully dissolves, the gravy will reach that perfect "country gravy" consistency.
Taste the gravy and adjust the seasoning. You will likely need to add more black pepper! Remove from heat, as the gravy will continue to thicken slightly as it cools. Serve immediately.