Grate the zest of 1 big organic lemon. If you want, you can set some aside for decoration.
Cook pasta in a large pot of boiling heavily salted water, stirring occasionally, until very al dente (pasta will finish cooking in the sauce).
While the pasta is cooking, add the cream to the pot with the lemon zest and honey cook over medium heat, whisking often, until liquid is just beginning to simmer. This should take about 2 minutes. Reduce the heat to medium-low. Whisk in the cubed butter 1 Tbsp. at a time until melted and sauce is creamy and emulsified. Remove from heat.
Just before pasta is al dente, scoop out 1 1/2 cups pasta cooking liquid. Add ¾ cup (180 ml) pasta cooking liquid to the cream sauce and return to medium heat. Add the cream cheese and stir to combine. Using tongs, transfer the cooked pasta to the pot with sauce. It's okay if a little bit of water comes along with it. I just dump the pasta into a sieve, take the sieve and transfer the pasta immediately.
Cook a minute tossing the pasta often and add the grated Parmesan little by little, until cheese is melted and sauce is creamy about 3 minutes. If the sauce needs thinning, add 1–2 Tbsp more of pasta cooking liquid. Remember that cream sauces thicken up even more as they cool, so it’s better to err on the saucier side. If you are using herbs, add them now right in the end and gently toss again. Serve with more Parmigiano for sprinkling on top. Taste and season with more salt, if needed.
Divide the pasta among two bowls. Season with freshly cracked black pepper, then top with reserved lemon zest and chopped pistachios.