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It is the Marxist version of the Christian idea that "people only reject Christianity because they want to sin."
 Original notion
The argument goes like this.
- Premise 1. The struggle between various social classes is the be-all-end-all of world affairs.
- Premise 2. In this struggle, members of each social class tend to look out for their own class interests.
- Premise 3. Fulfillment of the communist political program is an advance in the interests of the working class, and by extension each worker.
- Conclusion. All workers should be communists.
The question then becomes, why are all workers not communists? Since it would be too much to suggest that any one of the premises (particularly premise 3) is a pile of bunk, it must be that workers are just deluded, having been duped by the ruling classes into thinking that they are anything else besides workers, in an attempt to "divide and conquer" the worldwide proletariat. The ridiculous notion that the worker is actually an individual person is heavily frowned upon, as it tends to make him think he is somehow different from some other worker in Timbuktu, with different interests, thus ruining the abstraction (and also the worker's usefulness to the Party).
False consciousness is this notion that the worker is not first and primarily a worker.
When communists are not in power, the term sees use as an ad hominem attack of sorts against non-communists; often to prevent communists from listening to the arguments of such horrid reactionaries.
When communists do get into power, it can be used a little more. In the Soviet Union, that idea that opponents of communism were in massive denial, or otherwise not quite right in the head, was taken one step further, and political opponents were clapped up in booby hatches, diagnosed with such "diseases" as "Sluggishly Progressing Schizophrenia."
The theory of false consciousness has undergone modifications through the years.
Previously, communists had claimed that they were not in power because workers were being excluded from the political process. The lie was put to these claims when communists started losing free elections; in response, the Marxist philosopher Antonio Gramsci came up with the notion of "cultural hegemony." This was the idea that the ruling class uses cultural rather than political means to keep workers in false consciousness. Offshoots of this idea include Cultural Marxism and neoconservatism.
Later, with the advent of identity politics, in which various other identity groups took the place of the proletariat in the abstractions, the idea has become much more widely applied. The so-called "Uncle Toms," for example, who place their own interests above that of their perceived race, are seen as having false consciousness. Radical feminists are also particularly fond of the idea, which they borrowed directly from Marxism; they came up with the entire concept of "consciousness raising" in an attempt to dispel false consciousness among women.