They mostly have to do with predatory behavior. The second step in simple defensive training is to be sure it is given by an experienced expert. They are more likely listened to and less likely to give false advice than a novice or cottage industry self-defense instructor. Walking through hypothetical, situation-specific scenarios is particularly effective, and a few easily learned skills and responses are not readily forgotten. They can be reinforced by visualization exercises which can be done anytime.
Olympic athletes do that.
You wouldn't do that in your car. All of her training in how to manage assaultive and potentially violent patients in a relatively structured environment did not keep her alive. Unless you have practiced this you likely can't speak, let alone scream when being raped, and you certainly can't scream, if your own protective mace is being sprayed in your face. Training should address these questions and include going through those hypothetical mock exercises with coworkers. Yes, just like the police do in the movies.